The Inflation Reduction Act of 2022, signed into law on Aug. 16, 2022, is a significant piece of U.S. legislation that includes multiple initiatives on health care, climate change, and taxes. For Medicare beneficiaries, the new legislation means significant cost-cutting measures that will affect Medicare Part D - prescription drug coverage - for many years to come. Below, we’ve outlined some of the important changes that could affect you.
For those enrolled in a Medicare prescription drug plan, insulin copays will be limited to $35 per month starting Jan. 1, 2023, as long as the medication is included on the plan’s list of covered drugs, which is also known as the formulary. If you usually get a 60- or 90- day supply of insulin, your costs won’t be more than $35 for each month’s supply of covered insulin. Additionally, the Part D deductible will not apply to any covered insulin.
Starting in 2023, individuals with Part D drug coverage will pay little to no cost out-of-pocket for adult vaccinations recommended by the Advisory Committee on Immunization Practices. The shingles vaccine is among those covered.
Medicare will begin negotiating prices with manufacturers for certain drugs starting in 2023. The drugs will be selected from the highest-spending brand name Medicare Part B and Part D drugs that don’t currently have competition. Medicare will announce the first 10 drugs selected for negotiation in 2023, with final negotiated prices going into effect in 2026.
According to Medicare’s anticipated drug negotiation schedule, they will choose and negotiate costs for:
Manufacturers that don’t comply with the negotiation requirements will pay a tax and will have to pay additional penalties if they don’t fulfill other requirements outlined in their agreement with Medicare.
Among some of the most significant future changes to Part D after 2023 are:
A complete timeline with the Part D provisions of the Inflation Reduction Act can be found here.
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