Medicare in the New Year

BIG Changes Are On The Way for Medicare Part D Patients in 2025

Great news! There are two big changes in 2025:

1) The out-of-pocket prescription drug costs will be decreasing to a $2,000 maximum cap for the year.
– This includes all part D prescription medications – brand and generic

2) New for 2025 – the Medicare Prescription Payment Plan (MPPP)
– The MPPP is a new payment option that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. Enrollment in the MPPP is voluntary, and you will have the opportunity to sign up during open enrollment or any time throughout the year.

What does this mean for Medicare patients?

The changes for 2025 will make medications more affordable since the out-of-pocket cost is decreased. And since we know specialty medications can be very expensive, it may seem helpful that you can pay your $2,000 over the course of the year; however, the MPPP might not be the right decision for you.

If you have received funding or financial assistance in 2024, and your financial situation has not changed, then you can expect that you will receive funding in 2025. Our recommendation is that you do not enroll in the MPPP until we receive your first prescription in 2025. We will review your out-of-pocket prescription costs and assess your need for financial assistance. At that time, you will be able to determine if enrolling in the payment plan would be beneficial.

If you have concerns about the cost of your medications, contact our OncoAdvocate® Team today at 877.662.6633. They are a dedicated team of over 30 associates who are experts at finding third-party funding solutions for qualified patients so they can start therapy quickly.

If you would like more information for the Medicare changes in 2025, please visit: