My Medicare Part D premium is increasing — what should I do?
Dear Toni: I received my 2025 Part D premium with an increase from $25 a month to over $60. I was informed that my insulin and one of my high blood pressure prescriptions will no longer be covered, as of Jan. 1, on the Part D plan I am on.
Toni, please explain what I need to do to change my Part D plan before Medicare’s annual enrollment period ends on Dec. 7. — Joanne, Cypress, Texas
Dear Joanne: Many Americans need to change their Part D plans because of rising premiums or because their plan is no longer in Medicare’s network. It’s also an issue with Medicare Advantage plans.
First, let’s revisit Medicare’s Part D costs for 2025, and then I’ll explain how to find the right Medicare Part D plan to meet your prescription drug needs.
Medicare Part D costs for 2025 are:
■ Initial deductible: $590.
■ Initial coverage: There are five drug tiers. The Part D plan pays its share of the cost of your drugs, and you pay your share until the maximum amount of $2,000 out of pocket is met. Then you move into the catastrophic coverage stage and pay $0.
■ Coverage gap: Effective Jan. 1, the coverage gap, or “doughnut hole,” will no longer exist.
After accessing your Medicare.gov account, begin searching for your prescription drug plan following these steps:
■ Click on “Find health and drug plans.”
■ Verify your “Extra help” (based on income). List the pharmacies you prefer. Under “Your Drug List,” list all of your prescriptions. Enter them into the system on a monthly basis, rather than a three-month or six-month basis, because of Medicare’s new $2,000 out-of-pocket maximum rule. Using monthly rates lets you know when you will qualify for the $2,000 out-of-pocket maximum and no longer have to pay the deductible or copay for the rest of the year.
■ Click on “Find plan now” and click “2025” to find 2025 Part D or Medicare Advantage plans.
■ Select which plan you wish to enroll in, Medicare Advantage or Part D (stand-alone).
■ Explore your Part D options.
■ Your current plan will show up first with the 2025 premium. The plans listed after that are rated from least out-of-pocket cost to most. Now is your time to explore your options and choose the plan that best meets your prescription and financial needs.
■ For the drug plan you are exploring, under the section titled “Estimated total monthly drug cost,” it will show when you would meet the $2,000 out-of-pocket drug cost and your maximum 2025 yearly amount. Those with low drug costs will not have to worry about meeting the $2,000 maximum.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.
