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Medicare Part D Prescription Changes
The Centers for Medicare and Medicaid Services (CMS) has made significant changes to Medicare Part D plan design for prescription drug coverage starting January 2025. The changes are intended to make drugs more affordable and accessible. Key highlights include monthly payment options for covered high-cost medications and the elimination of the coverage gap after patients reach certain thresholds, reducing out-of-pocket cap on drug spending from $8,000 to $2,000. For higher cost medications, depending on plan coverage, some patients may see substantial increases to charges for the first refills of the year. The new monthly payment option can mitigate this situation.
We encourage patients to review their plan options to ensure their needs are met. You can learn more about what the changes may mean for you through your Medicare Part D plan using the contact information located on back of your insurance card. Patients who are insured by Network Health can contact advisors there at 866-845-1803. For general information, visit medicare.gov or call 1-800-Medicare. Pharmacy team members can also provide a broad overview of the changes.
Consider Managing Your Monthly Drug Costs with the Medicare Prescription Payment Plan
If you have received notice that you are Likely to Benefit from the Medicare Prescription Payment Plan, please review the linked information and contact Medicare for more information.
As your trusted health care provider, we want to make sure you have the resources you need to explore your Medicare plan options. Medicare is health insurance for people age 65 and older and you are first eligible to sign up for Medicare three months before you turn 65.
You can find more information about Medicare basics, how Medicare works, Medicare plan types and when and how to sign up at medicare.gov.
Connect With a Medicare Expert
For person-to-person assistance reviewing your Medicare plan options and help enrolling in a plan, call a local Medicare advisor, right here in Wisconsin.
Find a Medicare agent near you
Network Health Medicare Advantage Plans
Network Health, a Wisconsin-based health plan, provides a patient-centric, fully integrated approach to Medicare health insurance.
- Owned by Froedtert ThedaCare Health.
- Founded in 1982 by a small group of physicians.
- The National Committee for Quality Assurance (NCQA) awarded Network Health a 5.0 out of 5.0 rating for our Medicare line of business for 2024. This ranks Network Health in the top two of 622 health plans surveyed nationally. Network Health is the only Medicare Advantage PPO to achieve this distinguished honor, nationally.
For more information about Network Health Medicare Advantage Plans, visit networkhealth.com, schedule an appointment or call 844-201-0047.
Accepted Medicare Insurance
Froedtert & the Medical College of Wisconsin health network accepts most Medicare insurance. Holy Family Memorial is part of the Froedtert & the Medical College of Wisconsin health network. Froedtert South continues to operate as a locally led organization and retains its current health system departments, administrative services and insurance contracts.
See Lists of Accepted Insurance Plans
The Froedtert & MCW health network contracts with Medicare Advantage plans and Part D sponsors. The provider network may change at any time. You will receive notice when necessary. Enrollment in any Medicare plan depends upon contract renewal. For a complete listing of available Medicare plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult medicare.gov.
