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Major changes in 2025 include Medicare Advantage plans and a new $2,000 out-of-pocket max under Part D, eliminating "donut hole" coverage gap.
The new $2,000 out-of-pocket cap on prescription drugs covers everyone with a Medicare Part D plan, which is the section of Medicare that covers most pharmaceutical products. ... the coverage gap ...
Quarters of coverage. Monthly premium 2025. Cost increase from 2024. at least 40 quarters. $0. $0. at least 30 quarters or married to somebody with at least 30 quarters
The Medicare Part D coverage gap (informally known as the Medicare donut hole) was a period of consumer payments for prescription medication costs that lay between the initial coverage limit and the catastrophic coverage threshold when the consumer was a member of a Medicare Part D prescription-drug program administered by the United States ...
Several changes are coming to Medicare Part D prescription drug plans in 2025 that could impact drug costs and plan coverage. One change is an annual $2,000 out-of-pocket cap.
In 2012, the plan required Medicare beneficiaries whose total drug costs reach $2,930 to pay 100% of prescription costs until $4,700 is spent out of pocket. (The actual threshold amounts change year-to-year and plan-by-plan, and many plans offered limited coverage during this phase.)
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