Key Takeaways:An increasing number of older Americans struggle to afford the prescriptions they need to manage their conditions and stay healthy.As part of the Inflation Reduction Act, Medicare can now negotiate prices directly with drug companies to lower costs for both enrollees and taxpayers.Learn what this and other Medicare prescription drug changes mean for you or an older adult you care for. An increasing number of older Americans cant afford the prescriptions they need to stay healthy. In a recent study, roughly 1 in 5 people age 65+ took shortcutssuch as skipping doses or delaying refillsdue to financial worries.1 Said President Biden in a statement: For many Americans, the cost of one drug is the difference between life and death, dignity and dependence, hope and fear. That could soon change as a result of the Medicare Drug Price Negotiation Program. If you have Medicare, keep reading to find out how (and when) this program may affect you or an older adult you care for. What is the Medicare Drug Price Negotiation Program? The Medicare Drug Price Negotiation Program is part of the Inflation Reduction Act (IRA) of 2022, which includes several provisions to help lower prescription drug costs for people with Medicare. This provision will allow Medicarefor the first time everto negotiate drug prices directly with pharmaceutical companies. The goal is to improve the affordability of some of the most expensive drugs covered under Medicare Part B and Part D. Part B covers drugs administered by a physician. Reduced prices from drug negotiations for the first 10 drugs will take effect starting in January 2026. Going forward, the Centers for Medicare & Medicaid Services (CMS) will then select:         Up to 15 additional drugs to negotiate for 2027         Up to 15 additional drugs (including those under Part B) for 2028         Up to 20 additional drugs for 2029 and subsequent years Todays announcement is a game changer for the millions of older adults who rely on these medications every day," said Ramsey Alwin, NCOA President and CEO, in a statement on the start of drug price negotiations. "Our research shows that the cost of chronic conditions falls heaviest on women and people of color, who have the fewest resources. Lower prices are a matter of equity." A recent KFF survey showed strong bipartisan support (83%) for allowing the federal government to negotiate drug prices. Which prescription drugs will be negotiated? The drugs that qualify for Medicare price negotiation are from a list of high-cost, brand-name, single-source drugs that have no generic competition on the market. In 2022, Medicare enrollees paid a total of $3.4 billion in out-of-pocket costs for these medications. The 10 drugs selected for the first round of Medicare negotiation:         Eliquis: For preventing strokes and blood clots         Jardiance: For type 2 diabetes and heart failure         Xarelto: For preventing strokes and blood clots         Januvia: For type 2 diabetes         Farxiga: For chronic kidney disease         Entresto: For heart failure         Enbrel: For arthritis and other autoimmune conditions         Imbruvica: For blood cancers         Stelara: For Crohns disease         Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill: Insulin products for diabetes How will these changes affect me? Once fully implemented, the Medicare Drug Price Negotiation Program is expected to drop prices on negotiated drugs for up to 9 million older adults, who now pay as much as $6,497 out of pocket each year for these medications. People with Medicare will have better access to prescription drugs that help them manage chronic and life-threatening conditions. More older adults will be able to start medications, take them appropriately, and stay on them without making potentially dangerous trade-offs. Experts predict the program will also save taxpayers $160 billion by lowering Medicare costs. Other Medicare prescription drug provisions In addition to drug price negotiation, there are several other important provisions in the Inflation Reduction Act designed to lower healthcare costs for people with Medicare. Several provisions have already taken effect:         Medicare will cover a greater portion of the cost for high-quality biosimilars (drugs made from a natural source) for a period of five years, which began October 1, 2022.         Monthly out-of-pocket cost sharing for insulin is capped at $35.         Vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) are 100% free.         Drug manufacturers that raise their prices at a faster rate than inflation will face a financial penalty. Starting in 2024:         The 5% coinsurance for catastrophic drug costs will be eliminated.         Eligibility for the full Medicare Part D Low-Income Subsidy (LIS, also called Extra Help) will be expanded to beneficiaries with incomes up to 150% of the federal poverty level. LIS lowers premiums and out-of-pocket costs for prescription drug coverage.         From 2024-2029, annual Part D premium increases will be capped at 6%. Starting in 2025:         There will be a $2,000 annual cap on drug out-of-pocket costs. This could save beneficiaries $400 each year on prescription drug costs. Enrollees with the highest out-of-pocket drug costs could save $2,500 per year. In addition, the Medicare Prescription Payment Plan provision will allow enrollees to pay their out-of-pocket prescription costs in the form of fixed monthly payments over the course of the plan year (instead of all at once). These key provisions will help promote equitable aging by making vital medications affordable for more older Americans, says Josh Hodges, NCOAs Chief Customer Officer. Reducing drug costs will serve to improve the Medicare program now and ensure it remains strong and solvent for future enrollees. The Inflation Reduction Act also extends premium subsidies for the Affordable Care Act (ACA) Marketplace into 2025. As a result, an estimated 10 million people will save about $700 annually on their healthcare premiums. Source 1. Stacie B. Dusetzina, PhD et al. JAMA Network. Cost-Related Medication Nonadherence and Desire for Medication Cost Information Among Adults Aged 65 Years and Older in the US in 2022. May 18, 2023. Found on the internet at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805012This article was written by the National Council on Aging, September 14, 2023.

Forgetting pills happens to the best of us. While it may not be a huge deal occasionally, inconsistent medication adherence can be a significant problem for adults who take life-saving and quality-of-life medications. Sticking to a regular medication schedule reduces your risk of disease or complications. Theres an old saying in the medical world that medications dont work for patients who dont take them.There are lots of factors that impact medication adherence like high costs of medicines, inability to retrieve prescriptions, not having access to pills, and medication management. But the biggest reason is often the most obvious one: we simply forget to take our pills. With revolving schedules and tons of pills, it can be hard to remember to take one pill when you wake up, another with breakfast, another on an empty stomach, another when the sun is shining due south, and one before bed but after youve brushed your teeth. For those of us with complicated pill schedules, medication adherence can be a burden. Medication adherence is critical. Your doctor put you on your medicine for a reasonwhether its to control a disease, manage symptoms, or improve your quality of life. Its important to take your pills in the way theyre meant to be taken. Here are 13 of GoGoGrandparents go-to tips to help adults remember their pills and make medication adherence as natural and habitual as brushing your teeth. Use a clear, weekly pillbox. Pillboxes have compartments for each day and dosing time. A clear pillbox is a great visual reminder to see if you have already taken your pills for the day. A pillbox is also the simplest way to prevent double doses and missed doses. Plus, it makes life easier if you have a lot of medications because you can prep your pills in advance. Keep your pills visible. If theyre out of sight, then theyre out of mind, so make sure you put your pills somewhere youll see them. This might be the bathroom counter or bedroom nightstand for evening pills or in front of the coffee machine or toaster for morning pills.While you want your pills to be in a visible spot, you also should make sure they are in a safe place. Keep your pills away from direct sunlight, heat, and moisture to keep your pills from spoiling. Also, make sure your pillbox is safely secured from any children or pets. Pair taking pills with a habit you already have. For example, if you need to take a certain pill with food, make a habit of taking the pill before your first bite at each mealtime. Or take your morning pills with your first sip of coffee. Attaching taking your pills to habits you already have will make medication adherence much easier. Set an alarm on your cell phone or watch to alert you when its time to take your medications. Dont stop the alarm until youve taken the medicine. Snooze the alarm if you must so it doesnt slip your mind. Keep a calendar or medication journal. This will let you keep track of all the medicines and doses. List all of your medications including medication name, reason for taking, dose, frequency, time of day, and special instructions. For some people, a smartphone app is a convenient option. You might want to use this to keep track of when youve taken each pill. This is also a great list to have on hand when you visit the doctor. Use a dry-erase board to keep track of your medication compliance schedule. A dry-erase board works like a medication adherence calendar, but some people prefer a dry-erase board as a visual reminder.  At the beginning of the week, write on the board all of your doses for the week and then erase each dose after youve taken it. Place reminder sticky notes around the house to help remember to be adherent to medication. Place these on the fridge, bathroom mirror, or anywhere that will help you remember to take your pills.  Ask your healthcare provider to help come up with a medication adherence and administration plan. Your doctor will be able to create the most optimized treatment options, like simplifying medications or changing your frequency of doses. Ask your pharmacist if they offer reminder tops for your pills. These are pill bottles with caps that have reminder alarms for your medications. If your pharmacy doesnt offer these, you can buy some on Amazon as well and put them on top of your prescription bottles. Put refill reminders on your calendar. Not having any missed days is an important part of medication compliance. Making sure you have all of your prescriptions is critical to staying consistent. (Also, using a pillbox may help alert you in advance if you are running low on a certain prescription.)   Keep extra medicine in your bag or purse in case you get tied up away from home. You may also want to give extra medication to caregivers or family members, so they have some on hand just in case. The number one tip for medication adherence is to always make sure you always have your prescriptions on hand. The easiest, hassle-free way to get your prescriptions is through GoGoGrandparents prescription delivery service. GoGo offers prescription delivery for seniors and people with disabilities, so you can have your medications delivered right to your door. GoGo offers pickups from Costco, Walmart, CVS, your local pharmacy, and more so you can have prescriptions delivered from multiple locations.  You can even set up automatic pickups, so a GoGo driver will deliver your prescriptions on a regular schedule.Behind the scenes, GoGoGuardians monitor your prescription requests, track your delivery, and help make sure youre getting your medications on time. Thats what makes us different. We dont just deliver pills; we become a part of your care team to help you stay adherent to medication schedules. All you have to do is call 1 (855) 464-6872 and press option 6 to be connected to the GoGo prescription team, and well let you know when a driver is on their way! 

Receiving a denial at the pharmacy for a drug you need can be a stressful experience. When Medicare declines to cover a prescription, some might worry that they cannot afford the medicine out of pocket. Others might also need the treatment immediately and become concerned that the lack of coverage will adversely affect their health. Medicare can initially refuse to cover prescriptions for a variety of reasons, such as when your plan doesn't typically include your medication on its roster of covered drugs. Still, you have the right to ask your plan to cover the treatment you need and request an appeal if you disagree with your plans decision not to include your medication. Steps to Take Following a Prescription Denial If your plan doesn't cover a drug, inform the health care professional who prescribed it. Your prescriber might be able to find an alternative medication that your plan includes. For instance, you might be able to switch from a name-brand medicine to a generic one. In the event that there's no viable replacement for the medication or you aren't satisfied, you have the right to ask Medicare for an exception so that your plan covers the medicine. Your prescriber can also advocate for you and reach out to Medicare on your behalf. As a Medicare beneficiary, you have the right to receive a coverage determination outlining the reasons for the rejection, and you have the right to ask for an exception. While asking for an exception, it's helpful to have the support of your doctor or the person who prescribed the medicine. For instance, your doctor may help your case by writing a letter explaining why you need the medication. If, following your request, Medicare refuses to cover the medicine, you can appeal or appoint a trusted medical professional as your representative to appeal on your behalf. There are five levels to the appeals process. To begin this process, you can have Medicare issue a redetermination of your plan and then ask an Independent Review Entity to revisit it. The Office of Medicare Hearings and Appeals (OMHA) examines coverage decisions for drugs that meet a minimum value, and the Medicare Appeals Council reviews the judgments of OMHA. The medicine must cost at least $180 for an OMHA assessment. To reach this amount, appellants can combine the values of multiple drugs. When coverage denial persists, beneficiaries can appeal to the federal district court. To reach the federal district court, the minimum value of the treatments must be $1,760 as of 2022. How to Respond If You Need the Medication Immediately Those who need the medication urgently can request an expedited appeal and receive a decision on the exception request within 72 hours. Medicares failure to cover your treatment must compromise your life, health, or ability to regain maximum function. For assistance with appealing a coverage denial, speak with an attorney who understands Medicares appeal process.