I keep hearing about Medicare Part D changes for 2025. Will these actually lower what I pay for my prescriptions?

Question

Joseph Bachmeier · Accepted Answer

The biggest change in 2025 was closing the coverage gap also known as the "Donut Hole".
If your drugs are covered under your plan's formulary then you will spend no more than $2000 per year, no matter how expensive your prescriptions are. That is great news for folks who have been spending 4,5, 6 even 7 thousand a year. However, if you are taking a very expensive drug that is not covered under the Medicare formulary you could end up spending more than the 2K cap.

Lt Col Tim Brown · Answer

It could. If you are on expensive meds like Jardiance and Trulicity, the most anyone could pay in 2025, no matter how many meds they are on is $2,000. If your on generics, you will have cheap to no copays.

Answered by Lt Col Tim Brown on April 15, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent

Robert Pennington · Answer

The changes for 2025 will not affect prescription prices. Rather than have the donut hole and a $8000+ max out of pocket, the most any senior will pay in 2025 will be $2000. This can be set up on a 12 month pay from SS or you can pay as you go until you pay $2000 out of pocket and pay $0 for the rest of the year.

Answered by Robert Pennington on April 21, 2025

Broker Licensed in NC, GA, SC & VA

Answered by Robert Pennington Medicare Insurance Agent

Jonathan Potter · Answer

Yes, the cost for the part D plans did go up and the deductibles are very high but it will reduce what you pay for medications only if you take name brand drugs. If you don't take non generic drugs then you can get away with getting on the cheapest plan available. 

Lets say that you take a drug that costs $500 retail. The first month on the plan you would pay your deductible and then a copay of around $45. The next three months you would just pay the $45 copay. Then for the rest of the year that medication should be free because you have hit your $2000 max drug coverage.

Kent Pike · Answer

This overall is true, out of Pocket Cost have been lowered to $2,000 in Part D Expenses.  This has been a real game changer for a lot of people.

David Quintal · Answer

In 2025, Medicare Part D has several changes. The changes include a $2,000 annual out-of-pocket limit for prescription drug costs, the elimination of the coverage gap (aka "donut hole) and new options for spreading drug costs throughout the year.

Answered by David Quintal on April 21, 2025

Broker Licensed in NH, AL, AZ & 14 other states

Answered by David Quintal Medicare Insurance Agent

Joanna Gebhart · Answer

Yes, there were several changes to Medicare Part D for 2025. Many of the carriers have reduced the cost of some of the expensive medications. Additionally the Out of Pocket Maximum you will pay for all prescriptions is $2,000, down from almost $9,000 last year. The Donut Hole has been eliminated. This is a significant reduction and makes your annual cost much less. Additionally, there is a monthly no cost payment plan for those who know their medications will cost more than $2,000 in the year. This makes the monthly payment for all medications under $170 per month.

Answered by Joanna Gebhart on April 8, 2025

Broker Licensed in CA, OR & TX

Answered by Joanna Gebhart Medicare Insurance Agent

Robert Simm · Answer

For the majority of Medicare beneficiaries that have Tier 1 or tier 2 medications then they won't feel the impact of the new law under the Inflation Reduction Act. If your medications are coming up a little expensive when you pick them up at the pharmacy you can always reach out to your health insurance broker or insurance company to ask them if there's any reduction that you could possibly get for the cost of the medications or you can ask your provider to see if there is a financial incentive for the manufacturer the medication to reduce that cost there for you.

Answered by Robert Simm on April 7, 2025

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

Answered by Robert Simm Medicare Insurance Agent

Ron Gambles · Answer

As of today, the current cost structure is that the highest prescription drug deductible is $590. After that the cost to you will be 25% of the cost in the form of coinsurance until your prescription drug expenditure reaches a max of $2000. This includes any payments made on your behalf from the Extra Help program.

Answered by Ron Gambles on April 17, 2025

Agent Licensed in TN

Answered by Ron Gambles Medicare Insurance Agent

Sophia Davis · Answer

In many instances, yes! Most commonly used medications will remain primarily stable. Patients who take Tier 3 or higher medications, but not enough medications to reach the Max-Out-Of-Pocket threshold, will likely be most affected.

Answered by Sophia Davis on April 16, 2025

Agent Licensed in OH

Answered by Sophia Davis Medicare Insurance Agent

I keep hearing about Medicare Part D changes for 2025. Will these actually lower what I pay for my prescriptions?

Agents: Share Your Expertise

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

I keep hearing about Medicare Part D changes for 2025. Will these actually lower what I pay for my prescriptions?

Agents: Share Your Expertise

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website