2025 Drug Coverage Confusion

There was a good number of folks who contacted the SRA earlier this year when they started getting refills for their scripts and or going to their doctors.

Unfortunately, so many do not read the materials that are sent to each participant long before the new year begins and plan changes go into effect.

The below descriptions were taken directly from AT&T / UHC documents sent to all participants in the fall of 2024.

The design changes on the Grandfather plans may not hit all members the same way, but the value of each plan (average % of claims paid by the plan) remained the same or increased in 2025.

Design changes for Grandfathered retirees for the prescription drug plan

• Tier 1 deductible was reduced to 0 from $50.
• Deductible increased from $50 to $300 RX out-of-pocket maximum decreased from $6,500 to $2,000 (some of the members will see this benefit later in the year once their out-of-pocket costs hit the $2,000 max)
• Tier 3 copays were decreased from $120 to $83 for 30-day fill at retail and from $249 to $167 for 90-day mail order or CVS retail (likewise, some of the members will see the benefit of these decreased copays)

Prescription Plan Changes for NON-Grandfathered covered by the AT&T Medical Plan

• In addition, the Medicare Prescription Payment Plan was rolled out per the Inflation Reduction Act providing all retirees the options to spread their out-of-pocket RX costs across the calendar year. Retirees with higher out-of-pocket drugs costs early in the calendar year are likely to benefit from this program.  UnitedHealthcare notified retirees likely to benefit from this new program via mail or email based on their contact preferences.  If members have any questions about the program, they can reach out to UnitedHealthcare to discuss.
• The Coverage Gap, or “donut hole”, has been eliminated and your out-of-pocket limit (the amount you and others on your behalf pay) is $2,000. That means you’re more protected from high drug costs in 2025.

You may qualify for Extra Help from Medicare

Extra Help is a program for people with limited incomes who need help paying Part D premiums, deductibles and copays. There’s no penalty for applying, and you can reapply every year. To see if you qualify for Extra Help, call:

• The Social Security Administration at 1-800-772-1213, TTY 1-800-325-0778
• Your state Medicaid office