Medicare Corner
The $2,000 cap on out-of-pocket drug costs • Starting in 2025, your annual out-of-pocket Part D costs are capped at $2,000. After you reach this out-of-pocket limit, you will not owe anything for covered drugs for the rest of the year. • Your Part D plan should keep track of how much money you have spent out of pocket for covered drugs and your progression through coverage periods. This information should appear in your monthly statements. • Remember that only costs associated with covered drugs help you move through the coverage phases. If you spend money on non-covered drugs, those costs will not help you reach the annual cap. Changes to Part D in 2025
The Medicare Prescription Payment Plan (MPPP) • Beginning in 2025, you have the option to sign up for a payment plan for Part D out-of-pocket costs. • The MPPP allows you to spread your drug costs throughout the year, with the goal of helping you manage your monthly expenses. • For example, if you anticipate reaching the annual Part D cap quickly due to expensive medications, you can spread those costs throughout the year—rather than paying a lot in the first months of the year and nothing in later months of the year. • When you sign up for the MPPP, your plan will communicate your choice to your pharmacy. You should pay $0 at the pharmacy for your covered Part D drugs. Your plan will pay the cost-sharing at the time of your purchase and send monthly bills to you for the cost-sharing amounts. You will not pay fees or interest, even if your payment is late.
PCOA is your local State Health Insurance Assistance Program (SHIP) , and Senior Medicare Patrol (SMP) for Pima County. For assistance with your Medicare questions, contact us at (520) 546-2011 or email SHIP@pcoa.org . This project was supported in part by grant number 90MPPG0022, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.
March & April 2025, Never Too Late | Page 11
Pima Council on Aging
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