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News

Inflation Reduction Act (IRA) and Medicare

Posted on Friday, September 30, 2022 at 9:20 AM
Medicare Erie Pa

President Biden’s signing of the Inflation Reduction Act (IRA) marks the beginning of implementing many years of substantial change to the Medicare Part B and Part D programs.

How does the IRA impact 2023 Medicare Advantage plans (MAPD) and Prescription Drug Plans (PDP)?

 1: It limits the member cost-share on covered insulins to $35.

  • This means members won’t pay more than $35 for a one-month supply of each insulin product covered by their plan, no matter what cost-sharing tier it’s on, even if their plan has a deductible that hasn’t been met.
  • While some members already benefit from plans that offer $35 insulin, this legislation ensures that all seniors who use insulin benefit from this out-of-pocket cost limit.
  • Members receiving LIS will continue to pay the CMS statutory maximum cost share for insulin, which is less than $35.

 2: It eliminates member costs and improves access for Part D vaccines.

  • Many 2023 plans will cover most Part D vaccines for a $0 cost share, even if a plan has a deductible that hasn’t been met.
   


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