Every January, I speak with clients about their Medicare policies, and I often hear a similar theme; drug prices at the pharmacy are shockingly high! Sometimes manufacturers have increased drug prices, and sometimes there are no generic drugs available, but in most cases, those aren’t the issues.
Many seniors forget about the deductible within their Part D drug plan. In 2025 the standard drug deductible on most RX plans is $590. Complicating matters, that deductible doesn’t always apply to all drugs. The RX plan puts drugs in “tiers,” and only certain tiers (typically higher priced drugs) count toward that deductible.
The prescription deductible resets every January, often catching seniors by surprise. Members are responsible for the retail price of their medications until the deductible is satisfied. Once that happens, the price should lower, but it is challenging for seniors with expensive medications to suddenly pay over $500 in the first month of the year.
Many of you ask about finding a plan without a deductible, and while they do exist, their high premiums are another consideration. Some of the $0-deductible plans cost $60-$100 a month, negating any savings you would achieve with the low deductible.
For 2025, there is a $2000 cap on drug costs assuming they are on the formulary. You can also spread out the cost with monthly payments if that helps your budget.
It is important to re-evaluate your RX plan annually to ensure the plan you’re on is still the best fit for you. Remember, most of this analysis can be done on the Medicare.gov website, but we are always happy to walk you through it (at no cost to you!). Visit us at 2604 Long Prairie Road, Suite 100 in Flower Mound, or simply call us at 800-750-2407.
God Bless!
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