Changes to Medicare Part D Plans
Medicare Part D Prescription Plan news. Look for changes to Medicare Part D Prescription Drug Plans over the next few years.
Big news for retirees when it comes to a provision passed in the Inflation Reduction Act of 2022. Medicare beneficiaries will now have a cap on the maximum out of pocket they will pay for their prescriptions in a given year. Of course, the changes in Part D prescription cost sharing will not be immediate, but rather will be spread out over the coming years. Here is when everything is proposed to begin and what you can expect in the way of benefits.
Prescription Out of Pocket Costs Capped
- Full savings benefit set to begin in 2025 and the maximum out of pocket costs for prescriptions will be set at $2,000.
- The cap on prescription drugs will apply to those enrolled in stand-alone Part D prescription drug plans or thru the prescription benefit found in most Medicare Advantage plans.
- The $2,000 cap is not guaranteed to remain level. While there are not immediate plans to have the cap rise over the years, it could.
- If your current prescription benefit plan has a deductible, then that amount will also count towards the overall annual cap.
What To Expect Each Year
As it looks right now there will be no major changes to Medicare Part D prescription plans from the newly passed legislation for the remainder of 2022 and all of 2023. Beginning in 2024 Medicare beneficiaries will no longer have any out-of-pocket costs once they reach the catastrophic coverage level. Currently in 2022 this amount is $7,050 in out-of-pocket costs. So instead of now having to pay 5% of the prescription costs during the catastrophic level, there will no longer be any more out of pocket expenses.
Starting in 2025 all current levels above $2,000 in out-of-pocket costs will be phased out for Medicare beneficiaries. In addition, all Part D plans must offer an option that allows you to spread out the prescription costs over the plan benefit year. Why would you enroll in this option? The simple answer would be if you are someone who takes an expensive drug each month, you would not have to come up with a large amount of money at one time when first getting it filled, but rather spread those monthly amounts over the year. You would still be capped at $2,000 out of pocket expenses but wouldn’t have to possibly come up with a major portion of that in one month for a particular drug or combination of drugs (example would be someone who take multiple high-cost prescriptions each month).
Other Changes To Expect With Your Medicare Part D Prescription Plan
- Beginning in 2024 your Part D premium cannot increase more than 6%.
- Beginning in 2023 co-pays for insulin (30-day supply) to be capped at $35
- Beginning in 2023 will no longer have out of pocket expenses for certain vaccines (ex. Shingles vaccine).
Still have questions on how these changes to Medicare Part D Prescription plans impacts you, we can help! To read more about Medicare Parts and How They Work click here.