The Inflation Reduction Act will save money for people with Medicare by improving access to affordable treatments and strengthening the Medicare program. Here is what the law means for you:

Lower drug costs & improved Part D coverage

• The cost of a month’s supply of each Part D-covered insulin will be capped at $35, and you will not have to pay a

deductible for insulin, starting on January 1, 2023.

• If you get a 60- or 90-day supply of insulin, your costs cannot be more than $35 for each month’s supply of each covered insulin.
• 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.
• Get more information about this new insulin benefit.
• 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.
• Extra Help affording prescription drug coverage (the Part D Low-Income Subsidy (LIS) program) will expand to certain people with limited resources who earn less than 50% of the federal poverty level, starting in 2024.
• Your early Part D out-of-pocket costs will be capped at $2,000, starting in 2025. You will also have the option to pay out-of-pocket costs in monthly amounts over the plan year, instead of when they happen.

Medicare will negotiate to get you lower drug prices

For the first time, Medicare will be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that do not have competition.

• In 2023, we will announce the first ten drugs selected for negotiation.
  • Negotiated prices for these first ten drugs will be effective in 2026.
• Medicare will select and negotiate costs for:
  • 15 Part D drugs in 2025 (effective in 2027).
  • 15 Part B and Part D drugs in 2026 (effective in 2028).
  • 20 Part B and Part D drugs in 2027 (effective in 2029).
  • 20 Part B and Part drugs in 2028 and every year after.
• Manufacturers that do not follow the negotiation requirements will have to pay a tax and      will have to pay penalties if they do not fulfill other manufacturer      requirements.

Better access to vaccines

Starting in 2023, people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including the shingles vaccine, which are recommended by the Advisory Committee on Immunization Practices.

Do I need to do anything?

If you take insulin, get help comparing plan options and costs for 2023:

• Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
• Contact your local State Health Insurance Assistance Program (SHIP) to get free personalized health insurance counseling.

AEP is also a great reminder to review your Medicare plan each year so you can make sure you have the coverage you need going forward.

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Gr8 MEDICARE SOLUTIONS, 623 Lafayette Ave, Suite 204, Hawthorne, New Jersey 07506, (973)304-4269