Out of pocket prescription drug cost in 2025
I recently have had two compression fractures in my back. A doctor prescribed Forteo, a bone strengthening drug, which after insurance pays leaves a balance or about $950 a month. Under the new guidelines next year, would my costs be a capped at $2000 or can I be charged the approximately $12000 that isn’t covered by insurance.
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Terry Says
OK, I’m presuming you are talking about Medicare Part D (drug) coverage, so I talked with Thomas Dillon of J.T. Medicare Solutions. This drug, Forteo, is covered under drug plans (hope you checked that your 2025 plan covers it). And yes, the max out of pocket is $2,000 for 2025, assuming it is a covered drug in your plan.
Also, there is a new “payment plan” offered by Part D plans to spread out those payments over the entire year — so even if you hit the $2,000 cap in January, you can pay over the year ahead. Ask your plan about that.
