Medicare Part D Changes: What You Need to Know for 2025

Medicare’s prescription benefit, known as Part D, is set to undergo significant changes in 2025. The new rules aim to help Americans manage the cost of medications and make the program more sustainable.

The changes include a new smoothing option that allows enrollees to spread their co-pays for drugs covered by Part D over a single calendar year. This plan doesn’t save money overall but helps individuals manage out-of-pocket costs by dividing them into smaller monthly installments.

However, this option may not be worth it for those with inexpensive prescriptions, as it adds an extra monthly bill to cover the spread-out costs of co-pays.

To make informed decisions about Part D coverage, Medicare enrollees should explore online resources such as the Medicare plan finder and “Get What’s Yours For Medicare.” Local advisers, also funded by the State Health Insurance Assistance Programs, can provide additional assistance in navigating these websites.

The Inflation Reduction Act has already introduced changes to Part D, including a $35 monthly cap on insulin costs for diabetes patients. Other financial assistance provisions will help low-income seniors with Part D costs.

While it’s uncertain whether Republicans will seek to repeal or eliminate the new benefit changes, there is bipartisan support for caps on out-of-pocket Part D drug expenses. The Trump administration’s picks to lead CMS and the Department of Health and Human Services will shape future policy decisions, including those affecting Part D coverage.

Source: https://www.washingtonpost.com/business/2024/12/01/medicare-part-d-changes-2025-prescription-drugs