Since the insurance companies have not broadcast any of these new changes to agents regarding these changes yet, I decided to post this information as a courtesy to keep you updated.
As of this writing, this is the latest info that I received from a public source, regarding the new August 2022 bill passed that will affect Medicare Benefits. See web link to read the entire article.
https://www.nerdwallet.com/article/insurance/medicare/inflation-reduction-act-medicare
The Gist of the changes and the dates they are supposed to take affect are listed below. Most benefits are phased in during future years. (Please keep in mind this is from a public article source, and NOT from an “Official” Medicare or Insurance source.)
The Green highlights start in 2023.
Other benefits highlighted in Yellow start in future years.
Starting in 2025, out-of-pocket spending for Medicare Part D prescription drugs will be capped at $2,000.
That cap increases in subsequent years based on Medicare’s annual spending for covered drugs. If Medicare spends 5% more, for example, the cap for 2026 would be 5% higher: $2,100.
What it means for you: After you hit the $2,000 out-of-pocket cap in 2025, you won’t owe any more copays or coinsurance for covered drugs for the rest of the year (you’ll still have to pay your premiums). After 2025, the cap will be higher but still based on that $2,000 starting point.
Starting in 2024, beneficiaries won’t pay anything out of pocket in the catastrophic phase of Medicare Part D coverage. (This year only. - Because the $2,000 out-of-pocket cap goes into effect in 2025, this provision is really only relevant in 2024.)
Starting in 2023, drug manufacturers will have to send rebates to Medicare if their prices for most prescription drugs covered by Medicare go up faster than the rate of inflation.
Starting in 2024, the national base beneficiary premium for Medicare Part D plans can’t increase by more than 6% per year.
Starting in 2023, monthly out-of-pocket costs for covered insulin products will be capped at $35. Deductibles won’t apply to insulin products.
What it means for you: Your plan won’t be able to require more than $35 per month in coinsurance or copays for covered insulin products, even if you haven’t yet met your Medicare Part D deductible.
Note: Some current 2022 RX plans already have this $35/month max out of pocket for insulin, but it is limited to certain brands and is voluntary by insurance companies to include in some of their plans.
Starting in 2024, individuals with income up to 150% of the federal poverty level, or FPL, will be eligible for the full Medicare Part D low-income subsidy, also known as Medicare Extra Help.
Previously, the full subsidy was available at 135% of the FPL, and partial subsidies were available on a sliding scale between 136% and 149% of the FPL.
Starting in 2023, there will be no deductible, coinsurance or other cost-sharing requirements for adult vaccines covered under Medicare Part D.
What it means for you: You can get any vaccine covered by Medicare Part D without any out-of-pocket costs.
Medicare will start to negotiate prices for qualifying prescription drugs on which it has spent the most money: 10 drugs in 2026, 15 total in 2027, 15 total in 2028 and 20 total each year from 2029 on.
What it means for you: If you are prescribed one of the drugs with negotiated prices, you should see reduced prices starting in 2026.
Unfortunately, this is all I know from what I read publicly at this point.
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Similar info from another source:
Starting in 2023
Drug price increases will effectively be capped at the rate of inflation
Monthly out-of-pocket costs for covered insulin products will be capped at $35
Deductibles will not apply to any insulin products
Medicare covered adult vaccines must be at no cost with no deductible
Starting in 2024
Zero out-of-pocket costs for catastrophic Part D coverage (this year only)
Part D national base premiums cannot increase by more than 6% per year
The threshold for full LIS will be increased to 150% of FPL (currently is 135%)
Starting in 2025
Starting in 2025, the annual out-of-pocket Part D will be capped at $2,000
After 2025, the cap will increase based on Medicare’s drug expenditures
Starting in 2026
Medicare will start to negotiate prices, initially only on 10 qualifying drugs
Years 2027 and beyond
Negotiations will be expanded to an additional 15 drugs in 2027
Negotiations will be expanded to an additional 15 drugs in 2028
Negotiations will be expanded to an additional 20 drugs in 2029
Hope it helps!