Medicare Part D Prescription Benefits 

2025 Prescription Coverage Changes

No "Coverage Gap"

There will be only three Part D Payment Stages in 2025: the Deductible Stage (depending on your plan), Initial Coverage Stage, and Catastrophic Coverage Stage. The “Coverage Gap” (or “donut hole” stage), during which drug costs could significantly increase, has been eliminated.

$2,000 Out-of-Pocket Maximum for Covered Prescriptions 

In 2025, all Part D plans have an out-of-pocket maximum of $2,000. This means that once you have paid $2,000 for Part D covered prescriptions, you will pay nothing through December 31. This is significantly lower than the 2024 out-of-pocket maximum of $8,000.

Medicare Prescription Payment Plan

This program may be a helpful option to manage your monthly drug costs if you have high expenses early in the calendar year. It does not save you money or lower your drug costs.

MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For accommodations of persons with special needs at meetings, call 1-800-324-3899 (TTY 711).

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Last Updated: 10/1/2024