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Compare plans, check drug coverage, and enroll in the plan that works best for you.
You can sign up for Part D Prescription Drug Plans, which help cover prescription drug costs, along with other components of Medicare, starting three months before your 65th birthday or if you are under 65 and eligible for Medicare.
It’s important to do this on time because there may be a permanent premium surcharge for enrolling after your initial enrollment period if you don’t have equivalent drug coverage from another source, such as a retiree plan.
Suppose you are already enrolled in a Part D “standalone” plan or a Medicare Advantage plan that incorporates drug coverage. In that case, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year.
In 2025, several significant updates will affect Medicare Part D enrollees, including a substantial improvement with the implementation of a $2,000 out-of-pocket cap. This means that once you reach $2,000 in prescription expenses, you will not have additional out-of-pocket costs for the remainder of the year. This change represents a notable reduction from previous thresholds, aimed at helping individuals manage high prescription costs throughout the year.
Additional changes include the elimination of the “coverage gap” phase, sometimes referred to as the “donut hole,” where beneficiaries previously faced a change in cost-sharing. Starting in 2025, you will continue to pay consistent cost-sharing percentages in the initial phase, removing the complex transition to higher out-of-pocket costs that had occurred mid-year. The deductible is also rising slightly to $590 for many plans, although this may vary depending on individual plan details.
Part D drug benefits in 2025 are structured into three phases:
These updates aim to make Part D costs more predictable and manageable, especially for those with high-cost medications. The changes are part of the broader Inflation Reduction Act adjustments, which bring greater financial relief to Medicare enrollees in need of costly prescriptions.
It pays to review your Part D coverage every year, especially if you have started taking new drugs.
Call us to help you understand your options.
Individuals with 2024 annual incomes of less than $22,590 and financial resources of up to $17,220 or married couples with incomes of less than r $30,660 and financial resources of up to $34,360 might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.
See Medicare’s instructions on applying for the Extra Help program.
Additionally, read about the ways to lower your drug costs on Medicare.gov.
This information was obtained from www.medicare.gov
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“Not affiliated with the U.S. government or federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact MEDICARE.GOV OR 1-800-MEDICARE to get information on all your options.”