How the Inflation Reduction Act Affects Medicare

The Inflation Reduction Act is poised to save money for people on Medicare, starting this year.

For the first time, Medicare will be able to negotiate directly with manufacturers for the price of certain Medicare Part B and Part D drugs that don’t have competition.

Medicare Part D inflation caps now limit drug price increases to the rate of inflation. And starting this year, people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including those for shingles and Tdap.

The cost of insulin products will now also be capped at $35 per month. If you take insulin through a traditional pump that is covered under Medicare’s durable medical equipment benefit, that insulin is covered under Medicare Part B. These benefits go into effect on July 1, 2023.

Also going into effect this year: Part D premiums cannot increase more than six percent annually through at least 2029.

If you have drug costs high enough to reach the catastrophic coverage phase in your Medicare drug coverage, you won’t have to pay a copayment or coinsurance, starting in 2024.

Beginning in 2025, there will be an annual $2,000 cap on part D spending for beneficiaries. You’ll also have the option to pay out-of-pocket costs in monthly amounts over the plan year, instead of when they happen.

Starting in 2026, negotiated drug prices on expensive drugs with no generic or biosimilar equivalents will go into effect. Ten drugs will be on the list in 2026, increasing to 20 drugs by 2029.

The income threshold for Part D out-of-pocket subsidies is raised from 135% of the federal poverty level to 150%, starting in 2024.

Good news for those on Medicare!