The Donut Hole Is Gone in 2025
You no longer enter a coverage gap after reaching a certain spending level.
Medicare Part D now follows a simple three-phase structure.
Deductible Phase
- You pay the full cost of your prescriptions.
- The deductible is $590 in 2025.
Initial Coverage Phase
- You pay 25% of your drug costs.
- This phase ends once your total out-of-pocket costs reach $2,000.
Catastrophic Phase
- After reaching $2,000, you pay $0 for the rest of the year.
What Else Changes in 2025?
- $2,000 Out-of-Pocket Limit
- You’ll never pay more than $2,000 in covered prescription costs in a year.
- Premiums are not included in this cap.
New Manufacturer Discount Program
This replaces the old donut hole discount.
Manufacturers provide:
- 10% discount during Initial Coverage
- 20% discount during Catastrophic Phase
This applies only to brand-name drugs.
Monthly Payment Option
- You can choose to spread out your drug payments over 12 months.
- This is called the Medicare Prescription Payment Plan.
- It helps manage your monthly expenses.
$35 Insulin Cap Continues
- All covered insulin products are capped at $35/month.
- No deductible applies.
$0 Copay on Adult Vaccines
- All CDC-recommended adult vaccines are free.
- You won’t pay anything for them.
Talk to a Medicare Agent: 888.809.2440
- Want help reviewing your 2025 Part D plan?
- Contact one of our licensed agents.
- We’ll explain what’s covered and how to make the most of your benefits.
