07/20/2024
Good News! Part D (Rx) coverage is getting improvements in 2025
CMS is detailing improvements to the structure of the Part D drug benefit for Coverage Year (CY) 2025 that will result in lower drug costs for millions of people. Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.
Overview of Changes to the Part D Benefit
A newly defined standard Part D benefit design consisting of three phases: annual deductible, initial coverage, and catastrophic coverage - The coverage gap (donut hole) is eliminated.
A lower annual out-of-pocket (OOP) threshold of $2,000.
The establishment of the Manufacturer Discount Program.
Medicare Prescription Payment Plan
For the first time, beginning in 2025, the prescription drug law, known as the Inflation Reduction Act, requires all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage — to offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly payments instead of all at once at the pharmacy.
Open Enrollment begins October 15th and runs through Dec 7th. If you would like to review your coverage for 2025, please let me know!
I appreciate your business! Karen