Medicare Part D (Drug plan) changes for 2025
The U.S. legislature has made changes to Medicare Drug plans (Part D). For 2025 there will be a $2,000 cap on total out-of-pocket spending for drugs covered by your plan. Note the “covered by your plan”. If sometime during the year your doctor prescribes a new drug and it is not covered by your current Medicare Drug plan, the cost of that drug will not be included in the $2,000 cap. Yikes!
From the New York Times, “It’s Time to Shop for Medicare, and 2025 Brings Big Changes.”
Even though the law provides the new $2,000 cap on out-of-pocket drug spending for Medicare Part D plans, “the plan you’re in for 2024 may not be the best fit next year. Your premium and deductible might actually rise as insurance companies react to the changing rules, and a plan’s list of covered drugs might change.”
Stand-alone Part D prescription plans should be re-evaluated. In the past 2 years our Medicare Part D (Drug) plan premiums have nearly doubled (2023 to 2024: $35 to $65, 2024 to 2025: $35 to $55) and we have elected to change plans both years to keep the premium lower. So far our changes have not been a negative. The new plans cover our existing drugs and the premium was okay.
I will say it doesn’t seem right that as we age we have to spend so much time analyzing our Medicare insurance options. Medigap (Supplemental) Plans, Part D (Drug) Plans, and Medicare Advantage Plans all could have different options and premiums every year that has to be reviewed, analyzed, and possibly changed. The older we get the harder it is to do these reviews and changes.
You might be able to get assistance from these resources. Sometimes it depends on who answers the phone. If you are not comfortable speaking with the first person you talk with, thank them, hang up, and call again later hoping to get a different person. Some of these resources may not have the answers to your questions.
Medicare – 800-633-4227 ( https://www.medicare.gov/ )
State Health Insurance Assistance Programs (SHIPs) – 877-839-2675 ( https://www.shiphelp.org/ )
Your local Community Action Agency or Office on Aging. You may have to contact your local government or even library to get a phone number for these offices.