The 2025 Medicare Part D Communication Series is designed to provide you with updates throughout Medicare Part D open enrollment and into the new year.

If you haven't already, check out the new Medicare Part D section on the Member Portal. Select Medicare Part D from the main menu. Visit regularly for new and updated information and resources.

NOW LIVE: AlignRx 2025 Annual Medicare Part D Guide

The guide may be updated and reposted once AlignRx receives further plan information from PBMs.

To ensure you have the most updated version, please visit the Member Portal and select Medicare Part D from the main menu.

Inside the Guide

• High-level plan information organized by PBM
• How to report fraud, waste, and abuse 
• Links to useful websites
• List of acronyms and definitions 

For 2025 Medicare Part D, AlignRx is not contracted with:

• Aetna
• Caremark
• Express Scripts (includes Prime Therapeutics)
• MedImpact Update
• AlignRx will be contracted with certain MedImpact plans under the Medicare Part D networks from prior years. Specific plan information will be added to the guide as soon as AlignRx receives it from MedImpact.

The 2025 Medicare Part D Search Tool will be available prior to open enrollment.

The Search Tool includes a list of contracted plans. It provides extensive information, including but not limited to:

• Contracted plan information
• Network status – preferred, standard, or out-of-network
• Monthly premiums
• Annual deductibles
• Retail 30-day copays
• Extended-day retail copays (when available)

AlignRx developed a searchable reporting tool to identify patients whose plans will not be under contract with AlignRx in 2025. You can use this tool to determine which patients may need to be notified of plan changes.

This tool includes: Patient Information; Payor; Plan; BIN/PCN/Group; Rx Count; and Gross Profit Estimate.

Please visit the Member Portal and select Medicare Part D from the main menu. Then navigate to the Patient Data tab.

The Inflation Reduction Act (IRA) was signed into law in 2022. Key components for 2025 include:

• Medicare Prescription Payment Plan: Ability to pay out-of-pocket costs in monthly payments spread over the year
• Reduced out-of-pocket maximum of $2,000
• Elimination of the Coverage Gap or "donut hole"

The Centers for Medicare & Medicaid Services (CMS) recently published a new public-facing website with tools to help beneficiaries determine if the Medicare Prescription Payment Plan is right for them. The website contains examples of how monthly payments will be calculated and information on how to sign up for the Payment Plan. 

CMS also created Patient Fact Sheets and Take Away Cards to help beneficiaries understand how the Payment Plan can help them control their medication costs.

Click here for an overview of important changes for Medicare in 2025, including an implementation timeline of the IRA and frequently asked questions.

Please note: CMS is still defining details regarding the Medicare Prescription Payment Plan implementation. AlignRx will continue to provide information as it becomes available.

Need materials to inform your patients about Medicare Part D plans your pharmacy will/will not be accepting in 2025? Choose from a variety of marketing resources (such as a poster, flyer, postcard, and bag insert) that you can print in-house or send to a local printer.

Please visit the Member Portal and select Medicare Part D from the main menu. Then navigate to the Marketing Resources tab.

REMINDER: Your pharmacy can partner with Rx Insurance Group to provide Medicare plan guidance to your patients. Rx Insurance Group offers solutions to help guide patients in selecting a Medicare Advantage Plan, Medicare Prescription Drug Plan (PDP), or Medicare Supplement Insurance Policy (Medigap) that best meets their needs.

Learn more by clicking the "Medicare: Help Guide Your Patients" button on the Member Portal.

For questions, contact Matt Coakley: Matt@waypointus.com or 843-873-4420, x9

Rx Insurance Group Webinar: Options for Your Pharmacy

Register by noon the day of the webinar.

QUESTIONS? AlignRx Pharmacy Services: 844-ALIGNRX (844-254-4679), option 1