Prescription Drug Changes

The State of Maryland’s prescription drug plan coverage for Medicare-eligible retirees changed on January 1, 2025. The State-provided prescription drug plan with CVS/Caremark ended on December 31, 2024, resulting in many Medicare-eligible retirees transitioning to different coverage under Medicare. These changes have undoubtedly affected out-of-pocket costs and access to certain medications, creating challenges for many retirees.

If you are seeing higher costs, here are a few of the most common explanations. As a retiree you will need to contact Via Benefits for more assistance.

Medicare Part D 2025 Cost and Benefit Changes

The specific details of cost and benefits coverage for 2025 Medicare Part D prescription plans are now available on Medicare’s website. However, here is what we know:

• Deductible: Most plans have a deductible. In 2025, the maximum deductible is $590. You must pay this amount before your plan starts covering costs.
• Initial Coverage Phase: After meeting the deductible, you will pay a copay or up to 25% of drug costs during this phase.
• Out-of-Pocket Spending Cap: Once you’ve spent $2,000 on covered medications (including deductibles, copays, and coinsurance), you won’t pay anything more for the rest of the year.
• Catastrophic Coverage Phase: After reaching the $2,000 cap, costs will be covered as follows
  • Medicare Part D plans cover 60% of drug costs.
  • Drug manufacturers cover 40% of drug costs.