Lowering Medicare Costs This Open Enrollment Season

Health -- October 24, 2022: Medicare Cost Reduction During Open Enrollment
Seniors and other Medicare recipients will start to benefits of cost-cutting initiatives in January.

The Inflation Reduction Act is responsible for:

Beginning on January 1, 2023, the cost of a month's worth of insulin will be capped at $35.
Medicare recipients will not incur any out-of-pocket payments for any of the recommended adult immunizations covered by their Part D coverage, including the $200+ shingles vaccine.
Companies who attempt to increase their prescription medicine prices more quickly than inflation will be compelled to provide Medicare a rebate.
A survey from HHS earlier this year revealed that in only the previous year, the cost of 1,200 prescription medications increased more quickly than the rate of inflation. For instance, one manufacturer raised the cost of a medication used to treat high blood pressure and heart failure, which millions of Medicare recipients take, by about 540 percent in 2022. Just last year, the price of another medication used to treat autoimmune diseases rose by $1,000.

Seniors and other Medicare beneficiaries will have the option to select medication coverage that takes these new cost-savings into account during Medicare Open Enrollment, which runs from October 15 to December 7. This will allow them to save money.

Medicare recipients can check their options for the upcoming year at Medicare.gov or by calling 1-800-MEDICARE to ensure their health and prescription drug coverage is appropriate for them.

Using the HHS Innovation Center to Reduce Costs Even Further

President Biden will signed an executive order on October 14, 2022 directing the Department of Health and Human Services to consider further steps to significantly reduce the cost of prescription drugs as the Biden-Harris Administration works to execute the Inflation Reduction Act. This involves utilizing the "Innovation Center" at HHS, which was established by the Affordable Care Act and has the capacity to evaluate novel Medicare payment methods that raise care quality while cutting costs.

In order to continue on his Administration's efforts to reduce prices for working and middle-class families, the President will today sign an Executive Order directing the Department of Health and Human Services to investigate additional measures it can take to minimize prescription drug costs.

Cost of living pressures are felt by Americans; this has always been the case and was a major campaign issue for the President. Inflation is mostly being caused by rising health care expenditures. Too many Americans struggle to afford their prescription medications. One in four Americans who take prescription prescriptions struggle to pay for their meds, and on average, Americans pay two to three times as much for prescription drugs as people in other nations. A third of ten American adults who take prescription medications admit to skipping dosages, splitting pills in half, or not filling their prescriptions because of the cost.

The Inflation Reduction Act, which President Biden and Congressional Democrats introduced, addresses this issue and guarantees 13 million Americans lower health insurance premiums of, on average, $800 annually. It also lowers the cost of prescription drugs for seniors and sets a $2,000 annual cap on their out-of-pocket spending on medications. By gradually implementing a cap on out-of-pocket expenses at the pharmacy, establishing a $35 monthly cap per prescription for insulin, requiring businesses that raise prices faster than inflation to pay Medicare a rebate, and allowing Medicare to negotiate prices for expensive prescription drugs for the first time ever, the Inflation Reduction Act safeguards Medicare beneficiaries from catastrophic drug costs. Republicans in Congress have stated that repealing the Inflation Reduction Act, which would eliminate these cost-saving safeguards and raise prices for tens of millions of Americans, is their top goal.

The Treasury Department took action earlier this week to correct the so-called "family glitch" rule that was making it more difficult for families to obtain health insurance for their spouse or child in an effort to significantly reduce health care expenses. Due to the new regulation, around 1 million Americans will either receive insurance coverage or see a decrease in the cost of their coverage.

In accordance with the Executive Order, HHS will have 90 days to produce a formal report explaining any strategies for utilizing the Innovation Center's powers to reduce medication costs and support Medicare beneficiaries' access to cutting-edge drug medicines. The Inflation Reduction Act's groundbreaking medication pricing reductions would be expanded upon by this measure, giving American families more breathing room.


WNCTIMES by Marjorie Farrington

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