When 9 big medicare prescription changes take effect

2024 4. PART D OUT-OF-POCKET COSTS. Part D plan members whose high drug costs elevate them to the catastrophic coverage phase no longer pay out of pocket for the rest of the year. In 2024,

the out-of-pocket threshold for that coverage phase is $8,000, which includes your costs and drug manufacturers’ discounts. Previously, plan participants had to pay 5 percent of their costs

in this phase. 5. PART D PREMIUM LIMITATION. From 2024 through 2029, Part D plans can’t increase base premiums more than 6 percent a year. The base premium is $34.70 in 2024 and $36.78 in

2025. However, the base premium may not equal the total monthly premium that a plan enrollee pays. Because plan costs vary widely, premiums may have dropped for some while others saw

increases. Beyond 2029, the HHS secretary will determine the premium growth limit. 6. FINANCIAL AID. The government expanded eligibility for the Part D Extra Help program, which assists

people with limited incomes in affording prescription costs such as premiums and copays. The income limit to qualify for full Extra Help increased from 135 percent of the federal poverty

level to 150 percent, which is $22,590 for an individual or $30,660 for a married couple in 2024. 2025 7. OUT-OF-POCKET-CAP. The maximum amount that people with Medicare will pay out of

pocket for covered prescription drugs will be $2,000 a year. This new limit will apply to stand-alone Part D plans and drug coverage through a Medicare Advantage plan. An AARP report found

that nearly 3.2 million Americans are expected to save on prescription medications in 2025 because of the $2,000 cap. 8. HELP WITH PART D BUDGETING. Part D members will have the option of

spreading cost-sharing payments throughout the year, something Medicare calls “smoothed” cost sharing. This move is designed to protect people from being hit with one big drug bill, which

can discourage some from filling a prescription. People can opt into this Medicare Prescription Payment Plan through Part D. Video: These Medicare Changes Can Make Paying for Prescription

Drugs Easier 2026 9. PRICE NEGOTIATIONS. Consumers will begin to benefit from the first 10 prescription drugs subject to Part D price negotiations. In August 2024, Medicare announced

negotiated prices for the initial 10 drugs, which include expensive medications for arthritis, blood clots, cancer, diabetes, heart failure and kidney disease. Those prices take effect in

2026. Medicare will negotiate price reductions on up to 15 drugs for 2027 and 2028, and up to 20 drugs in 2029 and beyond. By 2029, as many as 60 drugs could be subject to negotiation. For

Medicare Part B drugs, typically administered in a hospital or doctor’s office, price negotiations will take effect in 2028. _This story, originally published Sept. 20, 2022, was updated

with additional information about the status of the changes and their effects so far._ Video: How Medicare Negotiations Impact Prescription Drug Costs