Capping The Cost On Prescriptions

Seniors Beware Of 2025 Medicare Plan D Changes

Local Open Enrollment COA SHIP Counselors Available

Prescription drug costs are a huge concern for a large number of seniors. Every year from Oct. 15 through Dec. 7, Medicare beneficiaries are able to see what their plan will look like for them for the following year and change it if necessary. With the changes to Medicare Part D slated to take effect on Jan. 1, this open enrollment period could be more important than ever.

Plan participants should expect to see changes to their plan premiums and increased deductibles. The 2025 standard deductible will be $590; up from the $545 deductible in 2024. But with that increased cost comes some good news for beneficiaries who have struggled with high prescription costs in the past.

Beginning Jan. 1, we will see the first-ever “cap” on the amount beneficiaries will pay for prescription drugs. The cap for 2025 will be $2,000; this is most you can pay between your deductible, co-pays and coinsurance. Please note your premiums and drugs not covered by your chosen plan do not contribute toward your cap.

In addition, a new Medicare Prescription Payment Plan will be added. This will allow people with Part D coverage the option to spread the cost of their prescription drugs out over the entire calendar year rather than trying to find a way to pay hefty price tags all within the first few months.

The Prescription Payment Plan is not mandatory and may not be right for everyone but for those who experience high prescription costs in the early months of each year, it may be a helpful tool. If you choose to join the payment plan, you would no longer pay for your prescriptions at the pharmacy. Instead, you would get a bill from your drug plan dividing the amount you would have paid at the pharmacy out over the number of months left in the year. As you fill new prescriptions your next month’s bill will change until the total amount of prescriptions reaches the $2,000 cap; at that point, your payment will remain the same for the remainder of the year. It is important to note that your total drug costs for the year will be the same whether you sign up for the Payment Plan or not. The Payment Plan will not reduce your drug costs but may make them more manageable in certain situations.

As mentioned earlier, drugs that are not covered by your chosen plan do not count toward the cap. As plans can change their covered drugs each year, it is very important to check your Part D plan during Open Enrollment to ensure that it will still cover your prescriptions in 2025. At that time, you can also decide whether the Prescription Payment Plan is right for you.

If you need help, the Commission on Aging has three certified SHIP counselors on staff to assist you. SHIP counselors are not insurance agents; they are specialists trained in Medicare eligibility, benefits and options that provide free local health coverage counseling to Medicare beneficiaries.

This Open Enrollment, COA SHIP Counselors will be available by appointment at the following locations:

Sidney Office (2190 W. Holly St): Monday-Friday

Fairview Senior Center: Wednesdays

Savage Senior Center: Oct. 31

Fox Lake Center (Lambert): Nov. 12

Historically, the COA’s SHIP appointments have filled up fast. Please call (406) 433-3701 to schedule your free appointment at your desired location.

 

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