Medicare Part D - Major Expected Changes For 2024 And 2025


Below are major expected changes for Medicare Part D (Prescription Drug Plans) in 2024:

  • In 2024, costs in the catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%.1

  • So in 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped. In 2024, the catastrophic threshold will be set at $8,000. This amount includes what Part D enrollees spend out of pocket plus the value of the manufacturer price discount on brands in the coverage gap phase. At this amount, Part D enrollees who take only brand-name drugs in 2024 will have spent about $3,300 out of their own pockets and will then face no additional costs for their medications.1

Then beginning in 2025, some of the major expected changes for Medicare Part D (Prescription Drug Plans) will be:

  • Elimination of the coverage gap phase for Part D plan beneficiaries!

  • $2,000 out of pocket spending cap for Part D plan beneficiaries.

  • A higher share of drug costs paid by Part D plans in the catastrophic phase

  • A new manufacturer price discount and reduced liability for Medicare in this catastrophic phase, and changes to plan costs and the manufacturer price discount in the initial coverage phase.



To read the entire article, click on the web link below:

https://www.kff.org/medicare/issue-brief/changes-to-medicare-part-d-in-2024-and-2025-under-the-inflation-reduction-act-and-how-enrollees-will-benefit/


1. Source: https://www.kff.org/medicare/issue-brief/changes-to-medicare-part-d-in-2024-and-2025-under-the-inflation-reduction-act-and-how-enrollees-will-benefit/


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