Are you currently a beneficiary of Medicare Part D? Are you interested in enrolling in Medicare Part D? In either case, the new calendar year of 2025 will bring big changes to your yearly health related expenses, specifically when it comes to the cost of your prescription drugs. If you’re someone who pays high costs in prescription drugs, these changes could make a real difference in the yearly financial burden on your wallet.
There are two new key developments:
A New Cap to Yearly Drug Costs: $2000
This new development will apply to all Medicare Part D recipients, regardless of whether you enroll in its new optional payment plan. Starting in 2025, the total out-of-pocket bill that recipients pay for their prescription drugs, will be capped at $2,000.
To be clear, this cap is limited to the drugs that are covered by your plan. Should you be prescribed drugs that are not covered by your plan, you could still end up paying more than $2,000 by the end of the calendar year.
To take full advantage of this new development ahead of its start date on January 1st, 2025, contact your plan provider to review your prescriptions and related coverage. If you are currently being prescribed drugs that are not covered, or if you expect to be prescribed drugs that are not covered, consider investigating a different plan.
A more expensive plan could very well be the more affordable option if you currently pay high costs for your prescription drugs due to poor coverage.
A New Payment Plan Option for Your Prescription Drugs
This new option is available to all Medicare Part D recipients, but requires enrollment; unlike the new cap to total out-of-pocket drug cost, this new option will not be applied to your plan unless you choose to enroll.
Without this payment plan, Medicare Part D recipients pay a single total bill once a year for the total cost of their prescription drugs. For many recipients, this means a hefty toll on their finances happening all at once. This new payment plan is meant to change that.
Instead of paying one large bill every year, this new payment plan would allow recipients to spread out the cost of their prescription drugs across the year, paying a smaller bill every month. That being said, to make full of use of this payment plan, it is highly important that recipients enroll as early as possible.
If a recipient enrolls in time for 2025, their out-of-pocket drug costs will be spread out over 12 months, but if they were to enroll in March, their payments would only spread out over 9 months.
It’s important to note, this plan does not lessen your costs, it only makes paying for your prescription drugs more manageable. Assuming all of your prescriptions are covered by your plan, you will never pay more than $2,000, and with this payment plan, that maximum would be spread out over 12 months.
What’s also important to note, is that this does not mean all bills will be an equal amount every month. And if any new prescriptions are taken on later in the year, they will only be spread out over the remaining months.
So When Should You Enroll?
The short answer as to when you should enroll is as soon as possible. Open enrollment for Medicare, and for the Payment Plan, begins on October 15th, 2024, and ends on December 7th 2024. Enrolling within this timeframe will mean that your healthcare plan, and the payment plan, would begin immediately on January 1st 2025. This would guarantee you the best use of the new payment plan, as you could take full advantage of all 12 months to spread your bills across.
After open enrollment ends, the next possible time of enrollment is January 1st, 2025, and any time after that. However, waiting too long to enroll will affect how much the payment plan can do for your finances.
What if You’re Not on Medicare Part D, but Want to Be?
This open enrollment period applies to all Medicare plans. If you qualify for Medicare, you can begin the application and enrollment process within the same time frame of October 15th through December 7th, 2024.
If you are interested in enrolling for Medicare, consider the following resources:
- Medicare.gov, or call 1-800-MEDICARE
- NHCOA Resource Center, via WhatsApp
- Online Healthcare Coverage Marketplaces unique to your home state.
If you are already a recipient of Medicare Part D, and have questions about the new payment plan:
- Contact your plan provider online or on the phone.
- Medicare.gov/prescription-payment-plan, or call 1-800-MEDICARE
- NHCOA Resource Center, via WhatsApp
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