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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.
Image source: Getty Images. 1. $2,000 cap on out-of-pocket prescription drug costs. The biggest Medicare change coming next year is a $2,000 out-of-pocket cap on prescription drug spending.
No Medicare drug plan may have a deductible more than $545 in 2024, up from $505 this year, plus “co-pays and what consumers pay for drugs inside their plans will also increase,” he added.
The amount of cost-sharing an enrollee pays depends on the retail cost of the filled drug, the rules of their plan, and whether they are eligible for additional Federal income-based subsidies. Prior to 2010, enrollees were required to pay 100% of their retail drug costs during the coverage gap phase, commonly referred to as the "doughnut hole.”
Enrollees paid the following initial costs for the initial benefits: a minimum monthly premium of $24.80 (premiums may vary), a $180 to $265 annual deductible, 25% (or approximate flat copay) of full drug costs up to $2,400.
Beginning in 2025, Medicare prescription drug plans must offer enrollees the option to spread their out-of-pocket prescription drug costs into monthly payments throughout the year, instead of ...
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