For over 40 years, Medicare beneficiaries paid out of pocket for most of their prescription medications. In 2006, the federal government opened a new program called Medicare Part D to help beneficiaries manage their prescription drug costs.
Medicare Part D is offered via private insurance companies, and you have the ability to comparison shop and choose a plan that best suits your needs.
Medicare Part D is voluntary, meaning you can choose to opt into a plan or not. If you do enroll in Part D, you will be able to access retail prescription drugs at a more affordable rate, and enjoy protection against catastrophic costs in the event you need a very expensive medication.
Changes Coming to Medicare Part D in 2025
Significant changes are coming to Medicare Part D in 2025, affecting premiums, drug coverage, and out-of-pocket costs. Stay ahead by understanding these updates and preparing now.
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 with Medicare through the release of the CY 2025 Part D Redesign Program Instructions. You can learn more about Medicare Part D for 2025 by contacting our office or by visiting Medicare.gov.
Changes coming to the Medicare Part D program in 2025 include:
- Elimination of the Prescription Drug Coverage Gap (Donut Hole) Phase.
- Capping annual out-of-pocket drug costs at $2,000 for individuals with Medicare Part D coverage.
- Requirement for all Medicare plans that include Part D coverage to offer enrollees the option of a Prescription Payment Plan.
- Part D plans and drug manufacturers will pay a larger share of drug costs to alleviate the burden on members.
Enrolling in Medicare Part D
You are eligible for Medicare Part D when you first become eligible for Medicare (at age 65). You can consult with one of our licensed professionals, who will be happy to explain your plan options, or you can enroll in a Part D plan directly through Medicare. Call 1-800-MEDICARE or visit Medicare’s website for enrollment information.
If you opt for a Medicare Part C (Advantage) plan, Part D coverage might already be rolled into that policy.
Since Part D coverage is offered through private insurance companies with plans that vary, you should carefully consider each plan’s formulary to ensure that your preferred drugs will be available through the plan.
If you don’t enroll in Medicare Part D when you are first eligible for Medicare, you can elect a plan later. Each year, during Medicare’s Annual Election Period from October 15 to December 7, you can add, drop, or change your plan selections.
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