Medicare is making changes starting January 1, 2025. These updates aim to make prescription drugs more affordable and easier to manage. Here is a guide to what’s coming and how it might affect you.

1. New Prescription Payment Plan (M3P)

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What’s New?

- Monthly Payments: Instead of paying the total cost of your prescriptions up front, you can now choose to pay in monthly installments.
- $0 at the Pharmacy: When you pick up your prescriptions, you will pay nothing at the pharmacy. Instead, your Part D plan will bill you monthly.
- Who Benefits?: If you have high out-of-pocket costs early in the year, this plan can help by spreading those costs out. However, if you qualify for Extra Help (Low-Income Subsidy), you might find that program offers better financial support.

Key Points

- Doesn’t Reduce Total Costs: The M3P helps you manage payments but doesn’t lower your overall drug costs.
- Flexible Enrollment: You can sign up for the M3P any time during the year. If you opt out, you’ll pay directly at the pharmacy again.

2. Changes to the Part D Benefit Structure

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New Benefit Design

-Three Phases:
 - Deductible: You pay 100% of your drug costs until you reach a $590 deductible.
 - Initial Coverage: You pay 25% of the cost of your prescriptions, leaving the remaining cost to your plan and drug manufacturers.
 - Catastrophic Coverage: Once you’ve spent $2,000 out-of-pocket, you pay no cost for your prescriptions. Cost coverages are by your plan, manufacturers, and Medicare.

What’s Different?

- Lower Out-of-Pocket Threshold: The threshold for entering catastrophic coverage is now $2,000.
- New Discount Program: The old Coverage Gap Discount Program will end, and a new Manufacturer Discount Program will start. This program provides more consistent discounts on drugs.
- Updated Cost Counting: Payments that count toward your out-of-pocket costs (TrOOP) will include some additional benefits and exclude new discounts.

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*To better understand these changes, look at the chart below, which shows the new structure of the Part D benefit.

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3. New Manufacturer Discount Program

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What’s Changing?

- Replacement for Old Program: The new Manufacturer Discount Program will take over from the old Coverage Gap Discount Program starting January 1, 2025.
- Discount Details: The program discounts certain drugs to manage costs effectively.

Why This Matters?

- Simpler Discounts: The new programs aim to offer clear and straightforward discounts on your prescriptions.
- Cost Control: It helps manage overall drug costs, making prescriptions more affordable.

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These changes to Medicare aim to make your prescription drug coverage manageable and understandable. The new Prescription Payment Plan offers flexibility, while the redesigned Part D benefit and the new Manufacturer Discount Program aim to make drugs more affordable.

Review your current Part D plan and see how these updates might affect you. For more information, visit [Medicare.gov] or contact your Part D plan sponsor.

Stay informed and take advantage of these new benefits to make your Medicare coverage work better for you!

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