Important Updates To Medicare: A Message To Patients

• October 16, 2024
• Jesse Smith
• Uncategorized

It’s important to know about big changes coming to Medicare Part D in 2025 that can help you manage your prescription costs more easily. We’ve learned that competing pharmacies or pharmacy-owned health plans may reach out and make it seem like your pharmacy options are limited.

Important: We partner with many Medicare plans and advise checking with our team before switching pharmacies

Medicare Part D Changes in 2025

Starting in 2025, Medicare Part D will have new rules
that cap how much you spend on prescriptions each
year. Here’s what will be different:

• $2,000 Out-of-Pocket Limit: In 2025, you won’t have to pay more than $2,000 for your medications in a year. Once you hit this limit, your Medicare plan will cover the rest of your prescription drug costs for the year. This can help save you money, especially if you have high-cost medications.
• No More Donut Hole: The “donut hole,” where people had to pay more for their medicines after spending a certain amount, will be gone. This means more predictable costs throughout the year.

Medicare Prescription Payment Plan (MPPP)

In 2025, Medicare will also offer a new way to pay for your prescriptions over time. This is called the Medicare Prescription Payment Plan (MPPP), and it allows you to split up your prescription costs into smaller monthly payments with no fees or interest.

This can be a great option to consider if paying for all your medicine at once is too hard.

• For example, if your out-of-pocket cost for a prescription is $2,000, you can choose to pay about $167 a month over 12 months, instead of paying it all at once.

How to Sign Up: You can sign up for this payment plan at any time during the year by:

• Filling out a form your Medicare plan provides
• Logging into your health plan’s website
• Calling the number on your health plan membership card

Things That Can Affect Your Monthly Payment:

• How soon you sign up
• How many medications you need
• Any cost-sharing required by your Medicare plan
• When you reach the $2,000 annual cap for your prescriptions

This new plan can be helpful if you struggle to pay for all your medications at once. Keep in mind, if you’re eligible for Medicare Extra Help, you may not need to use this payment plan.

To Learn More Contact:

Your health or drug plan

• Call the number on the back of your membership card or visit you plan’s website

Medicare

• Call 1-800-MEDICATE (1-800-633-4227), 24 hours a day, 7 days a week
• Teletypewriter/TTY users can call 1-877-486-2048
• Visit cms.gov

Your State Health Insurance Program

• Visit shiphealth.org