Part D Medicare alterations could spike premiums, limit options
TL/DR –
Changes to Medicare Part D prescription drug coverage are taking place over the next two years due to the Inflation Reduction Act. Some of the changes include a cap on annual out-of-pocket costs at $2,000 for Medicare Part D beneficiaries by 2025 and government-set prices for most-used drugs in the Medicare Part D program by 2026. However, concerns exist about a predicted 21.5% premium increase later this year, a smaller range of Part D plan options for patients, and an overall more expensive market with fewer choices.
Medicare Part D Prescription Drug Coverage Upcoming Changes
Medicare Part D prescription drug plan changes are coming due to the Inflation Reduction Act. These changes are being implemented over the next two years.
These modifications will cap annual out-of-pocket costs at $2,000 for Medicare Part D beneficiaries by 2025, and by 2026, the government will set pricing for the most-used drugs in the Medicare Part D program. Patient smoothing, which allows patients to spread drug costs over the year, began earlier this year.
Notable effects of the Inflation Reduction Act include a cap of $35/month for insulin for those with Medicare Part D coverage, and recommended vaccines are now available at no cost to those with Medicare prescription drug coverage.
The Council for Affordable Health Coverage pointed out that the Inflation Reduction Act shifts more insurance risk onto health plans and away from beneficiaries.
During a recent webinar hosted by Rural Minds and National Grange, Joel White from the Council provided insights into these changes, including benefits and potential drawbacks.
White views the security and overall lower costs for patients as significant benefits of Medicare Part D, but he has concerns about the future of the Part D market as new changes take effect.
“This law is causing a lot of disruption,” White stated, pointing out an anticipated 21.5% premium increase for October and fewer Part D plan options. “The challenge we see is more and more plans may choose to not participate in Part D.”
Since 2023, there’s been a drop of roughly 100 standalone plans in the Part D market. Without adjustments, White fears issues affecting patients in the system, predicting a pricier market with fewer choices.
Prescription Drug Assistance in Idaho
The Idaho Rx Card program offers up to 80% savings on prescriptions for low-income patients. For more information, you can reach them at (208) 297-3238.
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