Your Part D Part D, also known as the Medicare prescription drug benefit, is the part of Medicare that provides prescription drug coverage. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with a Medicare Advantage Plan. costs (including premiums, deductibles, and coinsurances or copayments) can change every year. Each fall, your plan should send you an Annual Notice of Change (ANOC) The Annual Notice of Change (ANOC) is a notice you receive from your Medicare Advantage or Part D plan in late September. The ANOC gives a summary of any changes in the plan’s costs and coverage that will take effect January 1 of the next year. Review this notice to see if your plan will continue to meet your health care needs in the following year. If you do not receive an ANOC, you should contact your plan. The ANOC is typically mailed or emailed with the plan’s Evidence of Coverage (EOC), which is a more comprehensive list of the plan’s costs and benefits for the upcoming year. to inform you of any changes for the coming year. Your plan cannot change your deductible The deductible is the amount you must pay for health care expenses before your health insurance begins to pay. Deductible amounts can change every year. or during the plan year, but the amount you pay for your drugs can change during the year based on which coverage period you are in. The chart below provides general Medicare drug costs for 2025.
| Medicare Part D costs | |
|---|---|
In 2025, you will pay: |
|
Monthly premium |
Varies by plan. National base premium is $36.78. People with high incomes have a higher Part D premium. |
Annual deductible |
Varies by plan. Cannot be more than $590 if you do not have Extra Help. |
Coinsurance/copays |
Vary by plan and by drug within plan. In all plans, after reaching $2,000 in out-of-pocket drug costs, you owe no cost-sharing Cost-sharing is the portion of medical care costs that you pay yourself, such as a copayment, coinsurance, or deductible, if you have health insurance coverage. See also: Out-of-Pocket Costs. for your covered prescription drugs. Many drug plans have preferred and non-referred pharmacies in their network. You may pay less for your drugs at in-preferred in-network In-network means part of a private health plan’s network of providers. If you use doctors, hospitals, pharmacies, home health agencies, skilled nursing facilities, and durable medical equipment suppliers that are in your Medicare Advantage Plan or Part D plan’s network, you will generally pay less than if you go to out-of-network providers. pharmacies. |
Medicare Prescription Payment Plan
All Part D plans must offer the Medicare Prescription Payment Plan. This payment plan allows you to spread your out-of-pocket drug costs throughout the year. This plan can help even out costs across the year if you meet the out-of-pocket cap or if you have high drug costs during part of the year. If you do not expect to meet the out-of-pocket cap and you have relatively stable drug costs through the year without the program, you may have higher costs at the end of the year if you opt in.
To opt in to the payment plan, contact your plan. You can opt in at any time, and there is no cost to participate in the program. Participating in the payment plan program does not change the total amount that you pay for prescription drugs. It does not decrease or increase your out-of-pocket costs Out-of-pocket costs are health care costs that you must pay because Medicare or other health insurance does not cover them. – it only changes when you have to pay.