Part D Spending Cap and Payment Program

February 26, 2024 Beginning in 2025, Medicare beneficiaries enrolled in Part D will not pay more than $2,000 out of pocket for Part-D-covered prescription medications. This change results from 2022’s Inflation Reduction Act and is aimed at making brand-name prescription drugs more affordable. “Too many seniors and people with disabilities can’t afford to fill their…

February 26, 2024

Beginning in 2025, Medicare beneficiaries enrolled in Part D will not pay more than $2,000 out of pocket for Part-D-covered prescription medications. This change results from 2022’s Inflation Reduction Act and is aimed at making brand-name prescription drugs more affordable.

“Too many seniors and people with disabilities can’t afford to fill their prescriptions at the pharmacy – and that is unacceptable,” says Health and Human Services Secretary, Xavier Becerra.

Also in 2025, Medicare Part D will begin allowing beneficiaries to spread out-of-pocket payments throughout the year in monthly payments, instead of paying the entire cost upfront. This will be known as the Medicare Prescription Payment Plan and is aimed at reducing high upfront prescription costs.

When will the payment plan take effect?

This plan will take effect in 2025, as part of the 2022 Inflation Reduction Act.

What is Medicare Part D?

Medicare Part D is also known as prescription drug coverage, and it is offered by private insurance companies. Part D is an optional add-on to Medicare Parts A and B. Beneficiaries can get Part D coverage alongside Original Medicare or bundled in a Part C Medicare Advantage Prescription Drug (MAPD) plan. Medicare Part D is optional, but late enrollees may be subject to a fee.

Read more about Medicare Part D