Pharmacy Pearls: Updates to Medicare Part D – Effective January 2025
October 28th, 2024 | Pharmacy•Pharmacy Pearls•Additional TopicsIn this edition of Pharmacy Pearls, you will find a review of the significant changes to the Medicare Part D payment structure for 2025 as a result of the 2022 Inflation Reduction Act. These changes are expected to lower out-of-pocket costs for Medicare beneficiaries by an average of 30%. The main changes are:
- A new benefit structure with 3 phases: deductible, initial coverage, and catastrophic coverage (no more coverage gap or “donut hole”)
- A lower annual out-of-pocket limit of $2,000
- The ability for patients to enroll in a yearly payment plan for their medications, which will result in $0 payments at the pharmacy and a monthly bill instead
The calculations for how much patients pay per month with the payment plan can be complicated and vary based on when the patient enrolls in the payment plan, how much their medications cost, and how much their medications change over the course of the year. There is an example of a January enrollment within the Pearl.
As always, we welcome any questions or feedback you may have. Just email the Pharmacy Team.
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