I recently had a question from a client regarding the annual $2,000 out-of-pocket maximum that’s now apart of every Medicare Part D drug plan. To be clear, the $2,000 max only applies to drugs that are covered on your particular drug plans formulary. Said another way, if a drug is not covered on your plans formulary, any monies spent on that drug will not count towards your $2,000 out-of-pocket maximum.
Related to this is the Medicare Prescription Payment Plan new for 2025. I know I’ve talked about this before, but this is a new program beginning in 2025, so I just want to make sure everyone is aware.
To summarize, the Medicare Prescription Payment Plan is a payment option that works with your drug coverage to help you manage your out-of-pocket costs for drugs covered by your plan by spreading the costs across the calendar year (January–December). Anyone with a Medicare drug plan can use this payment option. All plans offer this payment option, and participation is voluntary.
For those of you on the BlueCross BlueShield Part D Rx plan you can visit HERE for details and HERE to sign-up online if you like.
Farnum Health Insurance 