Part D Drug Plans
Part D drug plans are managed by private companies. They are available as either stand alone Part D drug plans or built into a Medicare Advantage plan.
First of all, big changes are coming in 2025 with Part D drug plans! If you have a Part D drug plan already, or need to enroll in one, reach out to see if you have an enrollment period and evaluate drug costs on the plans available to you.
2024 Part D Drug Coverage
In 2024, you are facing higher out-of-pocket drug costs before you can qualify for catastrophic coverage. The out-of-pocket spending threshold will increase by $600, from $7,400 to $8,000 in 2024.
You will also face higher out-of-pocket costs in 2024 for the deductible and in the initial coverage phase before reaching the catastrophic coverage. The standard deductible is increasing from $505 in 2023 to no more then $545 in 2024, while the initial coverage limit is increasing from 4,660 in 2023 to $5,030 in 2024.
For costs in the coverage gap phase, beneficiaries will pay 25% for both brand-name and generic drugs. Manufacturers provide a 70% discount on brands and plans pay the remaining 5% of costs for brand name drugs. Plans pay the remaining 75% of generic drug costs.
Clear as mud, right? Schedule an appointment and find out what all this means for your specific situation.
2025 Part D Drug Coverage
For the first time, Part D drug plans will be required to have a $2,000 cap on out-of-pocket costs for drugs on the plan’s formulary (list of covered drugs).
In addition this, there will be a new Medicare Prescription Payment plan. This will be a voluntary plan available to anyone on a Part D plan who has drug costs they would like to spread out. This will help prevent the roller coaster ride of Part D costs at the pharmacy. You can divide the estimate of your total drug costs for the year by the number of months you will be in the program to get a monthly amount. This can even be adjusted throughout the year if needed. You can join this plan in January or throughout the year. For more information, see Your Guide to Upcoming Part D Changes or contact us to help answer your questions. Every situation is different!
This information obtained from www.medicare.gov
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