Big Changes to Medicare Part D in 2025: What You Need to Know

Eli Lilly and Company is helping patients and caregivers understand important changes to Medicare Part D—set to begin in 2025.

To help explain the changes, Lilly field teams will provide brochures to doctors’ offices that can help easily explain the changes to patients and their caregivers

What is Medicare Part D?

Medicare Part D helps seniors pay for prescription medicines.

In 2025, three major changes aim to make medications more affordable and accessible.

What Are the Three Key Updates to Medicare Part D?

$2,000 Out-of-Pocket Maximum

• Starting in 2025, Part D enrollees won’t pay more than $2,000 annually for prescription drugs.
• After reaching this limit, no further costs apply for the rest of the year.
• This replaces the current $3,300 cap in 2024 and eliminates the coverage gap phase.

Monthly Payment Plan

• The Medicare Prescription Payment Plan (M3P) lets you spread out costs into manageable monthly payments.
• Sign up during Fall Open Enrollment (ends December 7, 2024) or through your drug plan later.

Expanded Extra Help Program

• More people qualify for the Extra Help subsidy, which lowers drug costs for low-income individuals.
• In 2024, individuals earning $22,590 or less and married couples earning $30,660 or less may qualify.
• Benefits include lower premiums, no deductibles, and reduced or no copays.

Appealing a Denied Medicine

If your drug is denied, you can appeal.

Standard appeals take 72 hours, while urgent cases are decided within 24 hours.

Key Dates

Open enrollment: Through December 7, 2024.
Updates take effect: January 1, 2025.

For questions, talk to your drug plan or visit Medicare.gov.

WRITTEN BY Daniel Trecroci, POSTED 11/21/24, UPDATED 11/21/24

Dan has written about diabetes for more than 20 years. He was one of Diabetes Health's first recruits, and throughout his 10 + years as Managing Editor he wrote/published thousands of articles and helped establish Diabetes Health as the premiere resource for people with diabetes. He later became the Content Manager for OneTouchGold—Johnson & Johnson/LifeScan’s official digital publication for its metering-technology customers. Under his leadership, OneTouchGold received the Web Marketing Association’s award for “Best Health & Wellness" web site. Dan has also written for the Diabetes Research Institute, dLife, diaTribe, Healthline, CareDx, Pendulum Therapeutics, and Hero Bread.