Medicare Part D Coverage Gap

Is the Part D Coverage Gap (Donut Hole) Going Away?

 

Yes. In previous years, you faced a coverage gap when you and your health plan spent a certain amount on your medications ($5,030 in 2024). After that you were required to pay 25% of your prescription drug costs until you reached an $8,000 annual out-of-pocket limit. Starting January 1, 2025, you will not pay anything for covered medications after you reach a $2,000 annual out-of-pocket limit.

 

Plus, the new rules make it easier to manage your out-of-pocket prescription drug costs. You can enroll in the new Medicare Prescription Payment Plan designed for members with high out-of-pocket prescription drug costs. This will let you make monthly payments versus paying the entire amount upfront. Participation in this program is completely optional. You will receive enrollment instructions from your health plan or give us a call if you have questions.

 

These changes also apply to Medicare Advantage plans that include prescription drug (Part D) coverage.

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Shop Anthem for a new Medicare Part D prescription drug plan

 

Consider comparing Medicare Part D plans every year to find a plan that is within your budget while providing the medications you need.

 

 

 

When is the best time to look for a new Medicare Part D plan?

 

You can make changes to your Medicare Part D plan during the Annual Enrollment Period, which is October 15 to December 7.

 

If you are just signing up for Medicare, you can also sign up for Medicare Part D during your Initial Enrollment Period (IEP). During this time, you can apply for Part D coverage along with Medicare Part A and Part B. To avoid penalties, it's best to enroll in Part D as soon as you're eligible, even if you are not taking prescription medications.

 

 

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What Is Original Medicare Part A And Part B?

Learn about Original Medicare Part A and B along with plans and benefit information. Visit the Anthem.com Official Site today for further information.
About Original Medicare

What is Medicare Part D?

Part D covers prescription drugs, which aren't covered by Original Medicare.
 Learn more about Part D

Why Choose Anthem?

We're here to help make your Medicare decision simple and stress-free.
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Anthem Blue Cross, a Medicare Advantage organization with a Medicare Contract, offers HMO, HMO D-SNP, HMO C-SNP, and HMO I-SNP plans. Anthem Blue Cross Partnership Plan, a Medicare Advantage Organization with a Medicare Contract, offers HMO and HMO-CSNP plans. Anthem Life and Health Insurance Company, a Medicare Advantage Organization with a Medicare Contract, offers LPPO, LPPO D-SNP, and LPPO C-SNP plans. Anthem Blue Cross HMO D-SNP plans and Anthem Life and Health Insurance Company LPPO D-SNP plans additionally contract with state Medicaid programs. Anthem BC Health Insurance Company, a Medicare Advantage Organization with a Medicare Contract, offers LPPO plans.  Enrollment in an Anthem Blue Cross, Anthem Blue Cross Partnership Plan, Anthem BC Health Insurance Company and Anthem Life and Health Insurance Company plans depend on contract renewal.