Lower Drug Costs and Improved Part D Coverage

One of the most significant changes under the IRA is the cap on insulin costs. As of 2023, the monthly expense of every Part D-covered insulin supply will be limited to $35, and you will not be required to pay any deductible for insulin. If you get a 60- or 90-day supply of insulin, your costs can’t be more than $35 for each month’s supply of each covered insulin. If you take insulin through a traditional pump that is covered under Medicare’s durable medical equipment benefit, that insulin is covered under Medicare Part B. These benefits go into effect on July 1, 2023.

In addition, the IRA will eliminate copayments or coinsurance for those who reach the catastrophic coverage phase in their Medicare drug coverage, starting in 2024. And if you have limited resources and earn less than 150% of the federal poverty level, you may be eligible for extra help affording prescription drug coverage through the Part D Low-Income Subsidy program, which will expand starting in 2024. Finally, your yearly Part D out-of-pocket costs will be capped at $2,000 starting in 2025, and you’ll have the option to pay those costs in monthly amounts over the plan year, rather than all at once.

Medicare Will Negotiate Lower Drug Prices

Another key provision of the IRA is that Medicare will now be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don’t have competition. In 2023, the first ten drugs selected for negotiation will be announced, and negotiated prices for those drugs will be effective in 2026. This will continue in the following years, with more drugs being selected for negotiation and effective dates for lower prices.

Better Access to Vaccines

Starting in 2023, people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including the shingles vaccine. This means that you’ll be able get the vaccines you need to stay healthy without worrying about the cost.

Key Takeaways

Overall, the Inflation Reduction Act is great news for beneficiaries on Medicare. With lower drug costs, better coverage, and improved access to vaccines, you can focus on your health and well-being without worrying about the financial burden. Speak with an Independent Insurance Agent to learn more about how these changes will affect you and what you can do to take advantage of them.