So I heard something about Medicare drug costs being capped at $2,000 in 2025. Is that really happening or just talk?

Answered by 4 licensed agents

It's very real. Medicare members are capped when your Part D or C plan's actual retail cost of covered drugs reaches $ 2,000 during 2025. Be sure to confirm that all of your meds are listed as "covered" drugs. Check your plan's formulary for that.

Answered by Clarence "Mark" Christiansen on April 4, 2025

Agent Licensed in WI, AZ, CA & 16 other states

Answered by Clarence "Mark" Christiansen Medicare Insurance Agent
It's definitely happening. The "Donut Hole" is gone which means that the only thing a client is responsible for is the Part D deductible, if applicable, and the prescription copay or coinsurance.

There may be instances where the annual cost is no where close to $2,000 which is a good thing but should the cost reach the catastrophic limit of $2,000, you will continue to receive the remainder of all prescriptions at $0 until the end of the year.

Answered by Timothy Brown on April 8, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent
Yes, it is inplace now under Medicare Part D & Medicare Advantage. Brought on by the Inflation Reduction Act.

Please call your Insurance Company to discuss your Policy. Further please go to

www.locatemedicareinsurance.com

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answered by Andrew Zurbuch, MBA on April 7, 2025

Broker Licensed in IN, FL, KY, MO, OH & TN

Answered by Andrew Zurbuch, MBA Medicare Insurance Agent
That law has gone into effect and medications are capped at $2000.00 for the year. If the medication is on a tier 3 then most insurance companies would apply that particular medication towards the deductibles so there will be a very high cost on medication in January then it starts to lower the co-payment throughout the rest of the calendar year the insurance companies do have a plan that helps Medicare beneficiaries with the high cost of medication so they can stagger that co-payment throughout the calendar year if need be.

Answered by Robert Simm on April 7, 2025

Broker Licensed in NC, AL, AR & 14 other states

Answered by Robert Simm Medicare Insurance Agent

Tags: Medicare Part D Prescription Drug

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