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How will the Inflation Reduction Act Impact 2025 Drug Pricing?

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As you have likely heard, the Inflation Reduction Act of 2022 includes several measures that will impact prescription drug costs for people with Medicare Part D coverage. These provisions will be implemented over a few years with one of the most significant changes starting on January 1st of 2025. As a result, reviewing your coverage options during this year’s Annual Enrollment Period will be essential!

In 2025, the annual out-of-pocket drug cost will be capped at $2,000 for individuals with Medicare Part D. While this is potentially good news for some individuals, there will likely be costs adjustments for most plans under the new model which includes a possible deductible of up to $590 and up to 25% coinsurance costs during the Initial Coverage Stage. There is also now a requirement for all Medicare insurance plans, that include Part D, to offer enrollees the option of a Prescription Payment Plan to make costs more balanced throughout the calendar year.

While we are still unsure of some of the implications of these changes on premiums and other factors like plan formularies and pricing tiers. We will have answers to these questions after October 1st which is why we recommend that you take advantage of our 2024 Readiness Steps:

  1. Do not leave it up to chance! Make sure to get on the schedule with us for a review during the Annual Enrollment Period (October 15 – December 7) to review your options.
  2. Prepare for the meeting by gathering a detailed list of prescriptions including the full name, strength, and frequency
  3. Write down your questions in advance so you do not forget to ask them during the review.
  4. Follow us on social media for the latest updates or click here to be added to our eNewsletter list.
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