By Jackie Dover
Things, they are a changing in Medicare, especially the prescription drug programs. Every year there are some changes to particular plans but 2025 will have big changes for Medicare Part D.
Open Enrollment for Medicare Part C and Part D plans is every year from October 15 through December 7 so now is the time to look at your current plan and see what will be best for the coming year. Medicare Part D plans send out an Annual Notice of Change (ANOC) in September to give you a heads up about what is changing with your plan. You should look over that form and take into consideration what will change with your current plan.
Plans can change the monthly premium amount, one plan will be increasing from $9.90 each month to $44.90, that is a huge difference and you don’t want that surprise in January when you can’t make a change. The deductible maximum is also going up to $590, some plans will have a lower one and some have no deductible. The most important yearly change is plans can change their formulary, which is what medicines are covers under a plan and what the co-pay amount is. You do not want to go fill a prescription in the New Year and find out it is not covered.
Some big changes for Medicare Part D is there will be an out of pocket spending cap on medicine for all Medicare Part D and Medicare Advantage Plans. This cap is $2,000 for 2025 and includes the amounts paid for the deductible, copayments and coinsurance on all covered medicines. It does not include the monthly premiums or anything paid for non-covered Part D drugs. This cap will eliminate the donut hole in its entirety.
In addition, in 2025, there will be a Prescription Payment Plan; this will allow Medicare Beneficiaries to spread out the cost of their prescriptions over the entire year. This could be beneficial for those with high drug costs; it allows you a set amount each month instead of the highs and lows when paying of the deductible. There will not be any additional fees or interest charged for this and it is open to all beneficiaries, no income guidelines. You will need to contact your prescription drug company to enroll. It is best to contact them earlier in the year so the amount can be spread out over a longer period. The payments are made directly to the plan, not the pharmacy and you will still need to pay the monthly premium for the plan.
Medicare.gov is the website to help determine what drug plan will be best for next year. At Aging Matters, we also look at which drug plan will best suit the beneficiaries’ needs for next year. Prescription information such as name of medicine, dosage and frequency are entered along with preferred pharmacy and zip code. The available plans are sorted by least expensive coverage. The costs for each medicine, the premium amount and the deductible are easy to see. You can also compare the Advantage Plans and see the different benefits they offer. This will allow you to make an educated choice about what coverage you want for next year.
When reviewing Medicare coverage for 2025 it is also a great time to check if there are any Extra Help programs you might qualify for. Those who meet the income and asset guidelines could get help to pay the Medicare Part D premium and help with co-pays for medicine.
Aging Matters will have Open Enrollment events at senior centers, libraries and other locations throughout our service area to assist Medicare Beneficiaries, let us know if you need assistance. To make an appointment for Medicare Part D or for more information call Aging Matters at 1-800-392-8771, because Aging Matters.