Changes would lower beneficiary spending, reduce Medicare’s liability for high drug costs, and increase Part D plan and manufacturer liability for high drug costs.
Beneficiaries:
- Eliminates 5% coinsurance for catastrophic coverage in 2024
- Caps out-of-pocket drug spending at $2,000 beginning in 2025
- Allows spreading out of out-of-pocket costs over the year
- Limits premium growth to no more than 6% per year for 2024-2030
Medicare:
- Lowers share of costs above the out-of-pocket spending cap (“reinsurance”)
Part D Plans:
- Increases share of costs above the out-of-pocket spending cap
- Modifies share of costs below the out-of-pocket spending cap
Drug Companies:
- Requires a price discount on brand-name drugs above the out-of-pocket spending cap
- Modifies the price discount on brands below the out-of-pocket spending cap
Have any questions regarding this notice? Don’t hesitate to call your Total Benefit Solutions Medicare health insurance specialists today at (215)355-2121.