Here are five things to know about the changes coming in 2025:
- Beginning in 2025, out-of-pocket costs for prescription drugs for Medicare beneficiaries will be capped at $2,000 annually.
- The changes led to higher premiums bids from Part D plans. The average bid for Part D plans increased 179% from 2024 to 2025, according to the Congressional Budget Office.
- In August, CMS pitched a plan to stabilize premiums. Most plans opted into the demonstration, which requires insurers to reduce base premiums for $15 a month for 2025. CMS will take on more risk for plans’ potential losses as part of the demonstration, costing $5 billion in 2025, according to the Congressional Budget Office.
- Starting in 2025, Medicare beneficiaries can opt into a cost-smoothing program to spread high one-time costs throughout the year.
- In 2024, CMS published negotiated drug prices for the 10 of the most expensive drugs with no generic or biosimilar alternatives. These negotiated prices will take effect in 2026.