$2,000 Out-of-Pocket Cap: The biggest change is that you'll no longer be stuck with runaway drug costs. Once you hit $2,000 in out-of-pocket expenses for covered medications, you’re done for the year. After that, no more payments on prescriptions for the rest of the year.
Goodbye, Donut Hole: The donut hole (or coverage gap) is gone in 2025. No more worrying about hitting that threshold where you pay more. It’ll be a straight line of coverage—pay your deductible, then a portion of your drug costs until you hit the cap.
Drug Discounts: Drug manufacturers will start giving discounts at different stages. You’ll get 10% off brand-name drugs during the initial phase and 20% off during catastrophic coverage.
Spread Out-of-Pocket Costs: If you’d rather not pay a big chunk all at once, there’s now an option to spread those costs throughout the year. This should help with budgeting and avoiding that painful “first month of the year” expense.
Premiums Adjusted: While the new benefits kick in, premiums are expected to rise slightly, with the base premium estimated at $36.78 per month. However, the government has capped any significant increases in premiums, so it shouldn’t go up too much
Make sure you review your plan during the Annual Enrollment Period to see how these changes might benefit you!
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