Medicare enrollers saw lower costs for 27 Part B drugs in April
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Some Medicare beneficiaries will begin paying less next month for 27 prescription drugs whose prices have risen at a rate that’s outpacing inflation, government officials announced Wednesday.
Depending on their individual coverage, beneficiaries could save anywhere from $2 to $390 per average dose on these drugs starting April 1. according to the Centers for Medicare & Medicaid Services. The reduced price applies to certain drugs and biologics administered in a hospital or other clinical setting — such as drugs used to treat cancer, arthritis, and chronic kidney disease — and are covered by Medicare Part B.
“Some of these drugs are life-saving for various conditions and situations like organ transplants,” said Elizabeth Gavino, founder of Lewin & Gavino and independent broker and general agent for Medicare plans.
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“It’s heartbreaking to hear stories from life-saving drug customers who are financially unaffordable due to fixed incomes,” Gavino said. “Reducing the cost may help some people.”
Beneficiaries who typically pay 20% co-insurance under Part B will see their share decrease due to a lower inflation-adjusted price for the drugs on this list. And the list of drugs affected by this coinsurance adjustment is subject to change on a quarterly basis.
The change is due to legislation passed last year
The cost reduction for these 27 drugs is due to the implementation of provisions in the Anti-Inflation Actwhich Congress passed last August.
The law requires drug manufacturers to pay a rebate to the Medicare program if their drug prices rise faster than the rate of inflation — which is not unusual. Half of all medications covered by Medicare had List price increases that outpaced inflation between 2019 and 2020, according to the Kaiser Family Foundation.
It’s worth noting that the law also applies to drugs under Part D, although information on which ones are subject to the inflation rebate won’t be available until later this year, said Juliette Cubanski, associate director of the Medicare Policy Program at the Kaiser Family Foundation. Additionally, these discounts in Part D do not result in lower costs for beneficiaries – this reduction only applies in Part B.
Additional changes to Medicare drug coverage are in effect
This isn’t the only change in drug coverage Medicare beneficiaries might notice this year.
The Inflation Reduction Act has also limited the monthly cost sharing for Insulin dispensed through Part D at $35, effective January 1. Part D deductibles — which vary by plan but cannot exceed $505 in 2023 — also do not apply to the covered insulin product.
For beneficiaries who take insulin via a traditional pump (which falls under Part B), the benefit begins July 1.
Also, starting this year, co-payments are no longer available for recommended Part D vaccines, including those for shingles.
More changes will come in the coming years
Other provisions designed to reduce Part D expenditures come into effect in later years.
This includes the elimination of an existing 5% co-insurance in the so-called catastrophe phase of coverage, which will come into effect in 2024.
Additionally, beginning in 2025, eligible beneficiaries will be capped at $2,000 annually on Part D. There is currently no deductible limit whether you receive your coverage as a standalone Part D option or through a benefit plan.
Medicare will also be able to begin negotiating the price of some drugs starting in 2026.
https://www.cnbc.com/2023/03/15/medicare-enrollees-could-see-lower-costs-on-27-part-b-drugs-in-april.html Medicare enrollers saw lower costs for 27 Part B drugs in April