Most Medicare beneficiaries are by now well aware that, beginning in 2025, the annual out-of-pocket cost for prescription drugs will be limited to $2,000. That’s a win for many beneficiaries, but not for all. Another wrinkle fixes that for some: the Medicare Prescription Payment Plan.  To understand how it works, let’s borrow an example from Medicare: Say you have several high-cost drugs that together cost you $500 a month. You would hit the $2,000 annual limit in April. But if you enroll in the new payment plan to start in January, you will spread out your pharmacy payments across the year, paying $166.67 a month. Slick.  You would still pay as much for your drugs across the year, but shed those crushing single-month costs.  To enroll in the payment plan, you would call your insurer – either your Medicare Advantage plan that includes drug coverage or your Prescription Drug Plan. Participating in the new payment plan is both free and voluntary.  Although the payment plan will be a boon to some, Medicare beneficiaries in several categories wouldn’t benefit. For example: If their annual drug costs are low or their monthly drug costs are constant all year; If they are enrolled in Medicare Extra Help that reduces pharmacy costs or they get significant savings from coupons, an organization or pharmaceutical manufacturer, or from a state drug program such as ArrayRxCard.com; If they don’t want to change how they now pay for their drugs; or If they enroll in the program so late in the year that it can’t help. The Medicare website describes the plan in detail. Also, September’s Medicare column in Salem Reporter outlined a dozen strategies for saving on prescription drugs, apart from the new payment plan. We have Oregon friends who are about to turn 65, but say no Medicare Advantage plans are available in their county. We would like to help them figure out what to do. You friends apparently live in one of a handful of Oregon’s less-populous counties where no Medicare Advantage insurance plan is offered. They have several options: Enroll in Medicare only, known as Original Medicare, with no additional insurance, and enroll in a separate Prescription Drug Plan to help with pharmacy costs. For medical expenses, they would be responsible for charges Medicare doesn’t pay (often 20% of the bill); Medicare has no ceiling on what their annual medical expenses could be. Enroll in a Medicare supplement (Medigap) insurance policy, whose monthly premium for the strongest policy (Plan G) for a 65-year-old would be roughly $140 (the precise number would depend on their ZIP code). Medigap Plan N is a worthy policy whose monthly premium is less. They would need to enroll in a separate Prescription Drug Plan, as well. If they want insurance, but want to avoid the premiums referenced above, they might enroll in a Medigap Plan G high-deductible policy. Their monthly premium would be approximately $40 a month, again depending on their ZIP code. During the year they would pay the share of medical bills that Medicare doesn’t pay up to an annual maximum of $2,800.  For any of these three options, they will need to enroll in a separate Prescription Drug Plan. Even if they take no prescription drugs, doing so would still be wise for two reasons: first, because they might have new prescriptions during the year and, second, to avoid a lifetime late-enrollment penalty later. For either of the Medigap options, they will have guaranteed issue to enroll – that is, no premium surcharge for a pre-existing medical condition – if they enroll during the first six months that they have Medicare Part B.  Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone, Zoom or in-person appointment with a volunteer Medicare counselor, call 800-722-4134. STORY TIP OR IDEA? Send an email to Salem Reporter’s news team: [email protected]. A MOMENT MORE, PLEASE– If you found this story useful, consider subscribing to Salem Reporter if you don’t already. Work such as this, done by local professionals, depends on community support from subscribers. Please take a moment and sign up now – easy and secure: SUBSCRIBE. The post COLUMN: What to know about Medicare prescription drug caps appeared first on Salem Reporter.