Are Medicare Drug Costs Increasing in 2025?

• Admin
• 25 Jan 2025

Are Medicare Drug Costs Increasing in 2025?

If you have Medicare Part D and rely on it to help pay for medications regularly, you’ll be happy to learn that changes are coming in 2025 that may help you save money. If you have high drug costs due to chronic conditions, you may be paying less out-of-pocket.

What is Medicare Part D?

Medicare Part D is prescription drug coverage. Individuals with Original Medicare Parts A and B can enroll in a stand-alone Prescription Drug Plan (PDP) to help cover their costs of medications prescribed by a doctor.

Millions of people eligible for Medicare choose to get their coverage through a Medicare Advantage (MA) plan instead. Offered by private companies, MA plans are required to include the same Part A and Part B benefits as Original Medicare, but most MA plans also include prescription drug coverage, among other additional benefits.

Will Medicare Part D Costs Change in 2025?

Most people with Part D will share the costs of their coverage through copayments, a deductible, and a monthly premium, which may vary among plans. In 2025, the base Part D premium is $36.78, an increase from 2024. Your total amount may vary based on your income, as reported in IRS tax returns.

The maximum standard deductible for a Medicare Advantage plan with prescription drug coverage in 2025 is $590. After meeting the deductible, you’ll be responsible for copayments, which differ by plan. There’s good news for people who have high drug costs—starting in 2025, Part D plans will have a $2,000 cap on out-of-pocket costs.

Your Costs with Medicare Part D

The total cost of your prescription medications under Part D will depend on multiple factors, including the plan you choose, your location, the pharmacy you use, and your individual health needs.

Switching Medicare Part D Plans

If your drug costs were high this past year or if your healthcare needs have changed, you may consider switching to a different plan during one of the following enrollment periods:

• Open Enrollment (October 15 – December 7): You can switch stand-alone Prescription Drug Plans (PDPs), switch from one Medicare Advantage plan (with or without drug coverage), move from Original Medicare to an MA plan, or revert to Original Medicare and enroll in a PDP.
• Medicare Advantage Open Enrollment Period (January 1 – March 31): You can make a one-time switch from one MA plan to another.
• Special Enrollment Period (SEP): If you experience a qualifying life event, such as becoming dual-eligible, moving into an institution, or getting married, you may be eligible to make changes to your plan.

As you review PDPs or Medicare Advantage plans with prescription drug coverage, be sure to compare both the costs and the benefits. If you are already taking prescribed medications, check the plan’s formulary to ensure the medications you need are covered before enrolling.