- For the first time, requires the federal government to negotiate prices for some top-selling drugs covered under Medicare
- Requires drug companies to pay rebates if prices rise faster than inflation for drugs used by Medicare beneficiaries
- Eliminates 5% coinsurance for catastrophic coverage in Medicare Part D in 2024, adds a $2,000 cap on Part D out-of-pocket spending in 2025, and limits annual increases in Part D premiums for 2024-2030
- Limits monthly cost sharing for insulin products to $35 for people with Medicare
- Expands eligibility for Medicare Part D Low-Income Subsidy full benefits
- Eliminates cost sharing for adult vaccines covered under Medicare Part D and improves access to adult vaccines under Medicaid and CHIP
- Further delays implementation of the Trump Administration’s drug rebate rule
As always, please contact your Total Benefit Solutions health insurance specialists with any questions or concerns at (215)355-2121.