As part of the Inflation Reduction Act (IRA), there have been some updates to Part D that aim to make prescription drug costs more affordable.
In 2024, Part D coverage included four tiers: annual deductible, initial coverage, coverage gap (aka the "donut hole"), and catastrophic coverage. For 2025, the coverage gap tier will be eliminated and there will be a more simplified structure.
The new Inflation Reduction Act (IRA) updated what counts towards True out-of-pocket (TrOOP) costs in 2025. TrOOP includes costs you pay out of pocket (e.g., your deductible, copays, and coinsurance) and some payments made on your behalf.
Most drug plans will release their 2025 plan benefits to the public by late September 2024.
Under the Inflation Reduction Act, covered insulin receives reduced cost-sharing for many Medicare beneficiaries.
Although new pricing will not be effective until 2026, Medicare has negotiated and finalized drug pricing directly with manufacturers for the following high-tier medications. Prices for the first 10 drugs will likely be effective Jan 1, 2026. More info available here.
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