Skip to main content
Woman in her 60s smiling at a man in his 60s while they sit on a park bench.

Not actual patients.

Stay up to date on your Medicare coverage

Important 2025 Medicare Part D Redesign Updates

Part D prescription costs will change in 2025. Part D may help cover the cost of prescription drugs like ENTRESTO®. For more information on the 2025 Part D redesign, review the Medicare and You 2025 handbook.*

Changes to Part D may include:

  • A redesign to the 3 phases which now include: the deductible phase, the initial coverage phase, and the catastrophic coverage phase. See below for additional explanation of each
  • With the redesign, the coverage gap phase will be eliminated
  • There will be a lower annual out-of-pocket threshold of $2000 (per calendar year)

Track your year-to-date costs and Part D coverage phases

As of 2025, Part D benefit consists of 3 phases: annual deductible, initial coverage, and catastrophic coverage.

Medicare will send you monthly statements with information on how much you’ve spent on prescription drugs and what phase your Part D coverage is in.

1

Deductible Phase:

  • You'll pay 100% of your deductible first, with a prescription drug cost of up to $590
2

Initial Coverage Phase:

  • Then, you’ll pay 25% per your plan’s co-pay and coinsurance for each of your prescriptions.
    Your plan will pay the rest
  • You’ll pay that amount until you have paid $2000 in total for all of your prescriptions
3

Catastrophic Coverage Phase:

After your total out-of-pocket costs for the year hit $2000, your plan and the manufacturer will pay the full cost of your medication. There is no coinsurance in the catastrophic phase for Part D beneficiaries.

  1. Clicking this link will open an independent third party website subject to its own Terms of Use and Privacy Policy. Novartis is not responsible for third party content and makes no representations as to the accuracy of information from third parties.

The information provided in this communication is not a guarantee of coverage or payment. Actual benefits are determined by each plan administrator in accordance with its respective policies and procedures. Nothing herein may be construed as an endorsement, approval, recommendation, representation, or warranty of any kind by any plan or insurer referenced herein. This communication is solely the responsibility of Novartis Pharmaceuticals Corporation.

Medicare coverage will
change in 2025

For more information on changes to come, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).*