What is new to Medicare Part D prescription drugs plans in 2025?
Even in case you don’t take a lot of medication now, having a Medicare Part D prescription drugs plan in 2025 is important for every person on Medicare. The purpose of Medicare Part D is to help lower your costs for prescription drugs. Part D coverage is available through private insurance companies in one of two ways; as a ‘stand-alone’ PDP (Prescription Drug Plan) or included in a Medicare Advantage (MA-PD) Plan.
How do Medicare Part D plans work?
Most Part D plans are using preferred pharmacy networks and formulary cost-sharing tiers, where out-of-pocket expenses are lower as long as you use those preferred pharmacies, and higher, if you purchase your medication outside the preferred network.
Premiums for Part D plans in 2025
All stand-alone Part D plans have a monthly premium, which varies by the plan, and is in addition to your Part B premium. If you enroll in a Medicare Advantage Plan that includes prescription drug coverage, your monthly premium for the plan typically already includes prescription drug coverage. Deductibles are also very common for Part D plans.
CMS.gov estimates the average premium for a basic Medicare Part D prescription drug plan in 2025 to decrease by $7.45 to monthly $46.50.
Your actual drug plan costs are subject to:
– the plan you choose
– your prescriptions
– your plan’s formulary (drug list)
– whether you purchase your medication at an in-network pharmacy of your plan
Prescription drug coverage through Part D is one of Medicare’s most popular plans, with over 50 million Medicare beneficiaries enrolled for prescription drug coverage.
New in 2025: Out-of-pocket cap at $2.000 on prescription drug costs
In 2025, your annual out-of-pocket costs for covered prescription drugs will be capped at $2,000. Once you reach this limit, you won’t have to pay any co-payment or coinsurance until the end of the year.
New in 2025: Medicare Prescription Payment Plan (optional)
A new payment option may help you manage your out-of-pocket drug costs, by spreading them across the year (January–December). You have to continue to pay your plan premium (if any) each month, and, instead of paying the pharmacy, your plan provider will bill you for your prescription drugs.
The Donut Hole 2025
With the new cap on your out-of-pocket costs, starting in 2025, there won’t be a coverage gap (formerly known as the Donut Hole anymore).
Available Medicare Part D plans in 2025
In 2025, competing insurers offer a broad spectrum of Medicare Part D plans with different benefits. You have two options to cover your prescription drug costs: First, a ‘Stand-alone’ Medicare PDP Part D plan, which can be added both to original Medicare itself or a Medicare Supplemental Policy (Medigap). Second, prescription drug coverage included in a Medicare Advantage plan (MA-PD).
No matter which solution you select, having a PDP is an important and valuable choice to help you with paying for high medication expenses. The numbers of available plans is huge, but it will depend on your local area which plans are available to you.
Compare Medicare Part D plans for 2025
It is very important that you thoroughly compare your plan options, no matter whether you intend to join a Part D plan for the first time, or are already enrolled in a plan. Premiums and benefits vary widely among plan policies, up to an estimated 20 percent.
Extra help for prescription drugs costs
For persons with limited resources who have difficulties paying the premiums and/or out-of-pocket costs for Part D, a federal financial aid program called Special Assistance is available to help. To find out, whether you qualify, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
