Medicare Part D changes for 2025

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For many Americans, last year was a big one for Medicare Part D coverage. There were numerous changes to how Medicare Part D plans help Medicare enrollees pay for their prescription medications. And while we won’t go into the details here, you can read our 2024 summary if you like.

In addition to last year’s updates, there are even more updates going into effect in a few months.

Let’s see what they are.

NEW! Out-of-pocket limit

Of the updates, this is one that’s gaining the most attention — and for good reason.

Starting in 2025, Part D enrollees will have a $2,000 out-of-pocket limit for their prescription drug expenses. This means that once a beneficiary has spent $2,000 on covered medications in a year, they will not have to pay any more for their prescriptions for the rest of that year.

To put that in perspective, between Jan. 1 and Apr. 1, 2024, more than 1.7 million people had already reached $2,000 in out-of-pocket costs on their prescription drugs.

Monthly payment plan coming

Starting in 2025, Part D enrollees will have the option to spread out their out-of-pocket costs over the year rather than facing high costs in any given month. This new Medicare Prescription Payment Plan will allow beneficiaries to manage their drug expenses more evenly throughout the year.

No more donuts

The coverage gap phase, also known as the “donut hole,” will be eliminated in 2025. This means that Part D enrollees will no longer face a change in their cost-sharing when moving from the initial coverage phase to what was previously the coverage gap phase.

Have questions? Help’s available!

With all the changes to Medicare Part D, and the fact plans can change each year, it’s natural to want to make sure you’re getting a plan that works for you and your situation. Three helpful resources could be checking out the Medicare Plan Comparison tool, calling your insurance agent, or accessing free Medicare counseling through your local State Health Insurance Program.