Chris Vedral, Magnolia Senior Benefits
Changes to Medicare in 2025
What changes are coming to Medicare Part D in 2025?
In 2025, Medicare will undergo some of the most significant changes in a generation. Changes to Medicare will include a $2,000 limit on out-of-pocket Part D drug costs, an opt-in payment plan, and some potential broad changes in Medicare Advantage plans.
Medicare Part D will see significant changes to the prescription drug program, including:
- Out-of-pocket drug spending cap – The out-of-pocket drug spending cap will be $2,000. This means that once a person reaches this cap, they won’t have to pay a copayment or coinsurance for the rest of the year.
- New Part D benefit design – The Part D benefit will be redesigned to include three phases: annual deductible, initial coverage, and catastrophic coverage. No more donut-hole.
- What’s the Medicare Prescription Payment Plan? – The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage, like a Medicare Advantage Plan with drug coverage, can use this payment option
What is Medicare Open Enrollment?
From January 1 – March 31, if you’re in a Medicare Advantage Plan, you can switch plans or return to Original Medicare and join a separate Medicare drug plan
- Switch to a different Medicare Advantage plan
- Switch back to Original Medicare
- Add a Medicare Part D prescription drug plan
During this time, you can get a second chance to make changes during Medicare Advantage’s special open enrollment period Jan. 1 through March 31.
Have questions or wish to schedule a free consultation, call or text 215-388-2158.