2025 Part D Landscape Files Reveal Plans Are ‘Managing Their Risk More Carefully’
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Oct 10, 2024
Because the Inflation Reduction Act (IRA) is making significant changes to the Medicare Part D benefit structure next year, industry watchers have been bracing for CMS’s release of the 2025 landscape files, fearing they would detail sharp premium increases for stand-alone Prescription Drug Plans (PDPs). While those fears have largely not come to fruition, experts say there is still evidence of plan sponsors subtly maneuvering to offset the risks associated with major policy shifts.
“Given all the changes in plan liability, I think we all expected really substantial changes in the cost to the consumer for Part D, so limited changes in plan premiums were a surprise,” Amanda Tripp, a principal at Avalere Health, tells AIS Health, a division of MMIT. Starting in 2025, the IRA will cap Medicare Part D beneficiaries’ out-of-pocket drug costs at $2,000 annually and change Part D plan sponsors’ cost liability past that cap to 60%, up from 20% in 2024 and 15% in 2023 and earlier.
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