Medicare Parts A and B, known as Original Medicare, do not cover most prescription drugs. To obtain prescription drug coverage, you can enroll in a Medicare Part D plan.
Part D coverage is available in two ways:
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Stand-alone Prescription Drug Plans (PDPs): These plans complement Original Medicare and any Medigap (Medicare Supplement) coverage you may have.
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Medicare Advantage Plans (Part C): Many of these plans include Part D coverage, combining hospital, medical, and prescription drug coverage into one plan.
When selecting a Part D plan, consider the following factors:
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Formulary: The list of covered drugs can vary between plans.
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Monthly Premiums: Costs can differ based on the plan and coverage.
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Copayments and Coinsurance: Out-of-pocket costs at the pharmacy.
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Plan Reputation: Consider the insurance company’s customer service and plan ratings.
Unlike Medigap policies, you can change your Part D plan annually during the Annual Election Period (October 15 – December 7) without medical underwriting.
2025 Part D Costs and IRMAA Surcharges
In 2025, the national base beneficiary premium for Part D is $36.78. Your actual premium may be higher or lower, depending on the plan you choose.
If your income exceeds certain thresholds, you may be subject to an Income-Related Monthly Adjustment Amount (IRMAA), which is an additional charge on top of your plan’s premium. The Social Security Administration determines IRMAA based on your reported income from two years prior.
Here’s a breakdown of the 2025 IRMAA brackets:
| Income Range (Individual) | Income Range (Married Filing Jointly) | Monthly IRMAA |
|---|---|---|
| $106,000 or less | $212,000 or less | $0 |
| $106,001 – $133,000 | $212,001 – $266,000 | $13.70 |
| $133,001 – $167,000 | $266,001 – $334,000 | $35.30 |
| $167,001 – $200,000 | $334,001 – $400,000 | $57.00 |
| $200,001 – $500,000 | $400,001 – $750,000 | $78.60 |
| Above $500,000 | Above $750,000 | $85.80 |
Note: These IRMAA amounts are in addition to your plan’s monthly premium.
Additional Information
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Payment of IRMAA: If you owe an IRMAA, you’ll receive a notice from Social Security. This amount is typically deducted from your Social Security check. If not, you’ll receive a bill from Medicare or the Railroad Retirement Board. It’s important to pay this amount to maintain your Part D coverage.
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Premium Deductions: You can choose to have your Part D premium deducted from your monthly Social Security payment. Contact your drug plan (not Social Security) to set this up. The first deduction may take up to three months to start, and multiple months’ premiums might be deducted at once initially.
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Appealing IRMAA: If you experience a life-changing event (e.g., retirement, loss of income, marriage, divorce), you can request a reduction in your IRMAA. To do so, complete Form SSA-44 and submit it to the Social Security Administration.
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Out-of-Pocket Cap: Starting in 2025, out-of-pocket costs for prescription drugs under Part D will be capped at $2,000 annually. This means once you spend $2,000 out-of-pocket on covered drugs in a year, you won’t pay more for your medications for the remainder of that year. The cap does not apply to non-covered / non-formulary drugs.