The changes in prescriptions for 2025 is great, but can also be a bit startling. In 2025, most plans will have a prescription deductible of which can be up to $590 (see Changes in Prescription blog). This deductible will count towards tiers 3-5 on most plans, some plans it is tiers 4-5. Now I personally would not be able to come up with $600 to pay at the pharmacy so starting in 2025, we are being given another option. The Medicare Prescription Payment Plan will spread out the total prescription cost for the plan year and divide that by the remaining months in the year. Please keep in mind the example below is an extremely simplified explanation.
My rough estimate for the year is $1,472, I would have to pay (on this specific plan) up to $495, before I only pay the co-pays. That would not be feasible for me so I would call Client Services on the back of my Insurance Card. I would request to sign up for the Medicare Prescription Payment Plan (M3P), it would become effective the 1st of the following month. If I were to apply today (1/21/2025) my effective date would be 2/1/2025.
The cost break down would look like this:
Total Estimated cost for Plan Year: $1,472
Total months left in year at effective date: 11
Equation: 1472 ÷ 11 = 134