I think my Part D premium is going up in 2023, which I expected. But I’ve also heard that everyone with Medicare might be saving money on drug costs because of recent legislation. How are drug costs changing in 2023?
-Jean-Claude (New York, NY)
It’s true that most people will experience some kind of change to their Part D costs each year. Part D plans can change the drugs they cover, their pharmacy networks, and their costs (such as premiums, copayments, coinsurance charges, and deductibles) from year to year. If you have Medicare prescription drug coverage, often referred to as Part D, your plan should have notified you about any changes in costs for 2023.
This year there are additional changes in Part D costs more generally due to the Inflation Reduction Act (IRA), which is likely the legislation you heard about. While some changes created by the IRA take effect in future years, the following changes take effect in 2023:
Insulin will be more affordable. The IRA limits co-payments to $35 per month for Part-D covered products and for insulin furnished under B, with no deductible for insulin products on your plan’s formulary. Currently, over 3 million Part D enrollees use insulin, and one in three people with Part D plans have diabetes. On average, in 2020, they paid $600 out-of-pocket for insulin. But some had considerably higher costs—25% spent over $800 and 10% spent over $1,300.
Because this change went into effect so quickly, the information about these lower costs was not always included in the Medicare Plan Finder tool during Fall Open Enrollment. This may have led some people to enroll in a plan that does not meet their needs. If you discover that you are not in the right plan, you may be able to change plans. Contact 1-800-MEDICARE (1-800-633-4227), your State Health Insurance Assistance Program (SHIP), or the Medicare Rights Center if you think this applies to you.
People with Medicare will be able to receive critical vaccines free of charge. The IRA eliminates cost-sharing and deductibles for Part D vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP), such as the shingles vaccine. This policy already applies to Medicare Part B and most private plans. Its expansion will save you costs and improve your access to necessary preventive care.
This will help the approximately 4 million Medicare beneficiaries who receive a Part D-covered vaccine each year. However, it will also reach millions more. Research shows Part D immunization rates are well below those for Part B, likely due to cost-sharing. The additional expense is a well established barrier to beneficiary receipt of recommended vaccines.
You can read more about IRA changes that will take effect in future years here.
How are drug costs changing in 2023?
January 2, 2023