Inflation Reduction Act 

2025:

• • Maximum out of pocket implemented
    • Medicare Beneficiaries with Part D Plans cannot pay more than $2,000 in out of pocket costs for medications.
    • The cap may be adjusted each year for inflation.
  • Medicare Prescription Payment Plan implemented
    • Payment Plan Fact Sheet
    • Implementation timeline 

2024-2026:

• • Part D premium increase cap of 6%/year

2022- 2024:

• • Inflation protected medication costs
    • As of 10/01/2022 pharmaceutical manufacturers must pay a penalty if the cost of a medication increases faster than inflation over a 12 month period

• • Coverage for Shingles Vaccine at no cost
    • All adult vaccines recommended by the Centers for Disease Control and Prevention will be covered by Part D Plans without imposing Plan deductibles or cost sharing.
    • Also includes Varicella (chicken pox),Hepatitis A, Hepatitis B, Meningococcal B vaccines
    • The following vaccines are currently covered under Medicare Part B and therefore are not impacted by the new legislation: Influenza, COVID, and Pneumococcal/Pneumonia

• • Injectable Insulin’s = $35/month and not subject to the Plan’s deductible.
    • Included = Injectable insulins (either vial or pen) which are included in a Plan’s Part D Formulary (list of covered medications)
    • Not included = Oral diabetic meds or injectable A1C meds.

• • Removal of 5% co-insurance during catastrophic phase