Medicare Part D is expected to have several changes in 2025, including:
Annual out-of-pocket cap
The annual out-of-pocket cost for prescription drugs will be capped at $2,000 for all Part D enrollees. This change/cap is a result of the Inflation Reduction Act (IRA) of 2022. The cap will be adjusted for inflation each year after 2025.
Elimination of the coverage gap phase
The coverage gap phase/donut hole will be eliminated.
Medicare Prescription Payment Plan
All Part D plans will offer enrollees a Medicare Prescription Payment Plan called MP3. This option allows enrollees to spread out their prescription drug costs throughout the year. The insurance carriers will be sending directions to each client.
New mid-year notification
Medicare Advantage plans will be required to send policyholders a personalized “Mid-Year Enrollee Notification of Unused Supplemental Benefits” statement in July of each year. It will list all supplemental benefits the policyholder has not used, the scope and out-of-pocket costs for claiming each one, and insurance on how to access the benefits.
Please be sure to look for your renewal information. You should receive it by the end of September. Let us know if you have questions, need assistance, or want to make changes.