Below are some of the major 2025 changes for Prescription Drug Plans.
(These changes also include Medicare Advantage plans that include Prescription Drug Coverage in their plans.)
The good news:
- Coverage Gap is gone for 2025
- Maximum Out Of Pocket expense for “Covered” Part D (Prescription Drugs) is $2,000/year
- Medicare Prescription Drug Payment Plan (This option allows members to spread the costs of their Part D drugs equally each month for the remainder of the year. This option however doesn’t alter the costs of the drugs, but it just allows members to spread the costs of their Part D drugs over the year. That way there are not such high “upfront” costs towards the beginning of the year.)
- Medicare has begun negotiating some drug prices directly with manufacturers and has capped certain medications to more affordable levels. (Example: Covered insulin is now capped at $35.00.)
The not so good news:
- Note: Part B Drugs are not included in the Part D Drugs Maximum Out Of Pocket Limit.
(Part B drugs are drugs that are administered by doctors.) - Because of the maximum $2,000/year out of pocket for Part D drugs, there will be higher upfront costs such as deductibles, and possibly higher copays or coinsurance for members to pay.
- Plan formularies (List of drugs covered by plan) possibly may be more limited and drug tier levels may change from prior year.
Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.
By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.
By calling this number, I understand I will be directed to a licensed insurance sales agent.