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Changes are Coming
Michelle Walters • May 29, 2024
Medicare Prescription Drug Plans to Change in 2025
In April 2024, the Health and Human Services (HHS) administration and the Centers for Medicare & Medicaid Services (CMS) released its final ruling on changes we can expect to see for the 2025 Medicare Prescription Drug Plans (Part D or PDP plans). These include, but are not limited to:
- Stages -
- Stage 1: Deductible - up to $590 for the calendar year
- Stage 2: 25% cost-sharing - until the Medicare Beneficiary reaches Maximum Out-of-Pocket
- Stage 3: Catastrophic - Covered in full for the balance of the calendar year
- Elimination of the "donut hole" or coverage gap
- $2,000 Maximum Out-of-Pocket for 2025
- Optional monthly payment plan to spread out the $2K
It is also estimated that the average cost of a stand-alone prescription drug plan will likely double. This means that the late enrollment penalty assessed for individuals who have not been covered by a creditable drug plan with also increase.
As more guidance is released, we will be absorbing and formulating a game plan to address these updates with our clients. Stay tuned in for more!