New 2023 Prescription Drug Law

Author

Crystal Manning Medicare Advisor

Posted on

Jun 06, 2023

Book/Edition

Pennsylvania - Greater Pittsburgh Area

A new prescription drug law that went into effect January 1, 2023 will help save money for people with Medicare. This law improves access to affordable treatments and strengthens the Medicare program.


In addition, several changes to improve the way Medicare beneficiaries can access behavioral health care will take effect in 2023. Changes could also be coming to telehealth.



Beginning in 2023, under a provision in the Inflation Reduction Act, Part D enrollees will pay no more than $35 per month for covered insulin products in all Part D plans, and will pay no cost sharing for adult vaccines covered under Part D.


Under the provision, copays for a 30-day supply of any insulin that a Medicare drug plan covers will be capped at $35. Enrollees won’t have to pay more than $35 even if they have not yet met their annual Part D deductible. Note that not every plan covers every type of insulin.



Also under the new law, vaccines recommended for adults which are covered under Part B are already free to Medicare enrollees. Others are covered by Part D prescription drug plans and require beneficiaries to pay some of the cost. These include shots for the flu, pneumonia, COVID-19 (initial shots and boosters) and hepatitis B for some enrollees are free under Part B and that coverage will continue in 2023. Part B also covers vaccines needed to treat certain injuries or exposure to a disease. Those include hepatitis A, rabies, and tetanus.


Other vaccines, most notably the two-dose Shingrix which guards against shingles, are covered under Part D prescription drug plans but may require cost sharing depending on the plan. Shingrix, for example, can run as much as $200 a dose.



Another provision of the new law that will be fully effective in 2023 requires pharmaceutical manufacturers to pay a rebate to Medicare if they raise prices of their drugs more than the rate of general inflation.



I am an independent Medicare Advisor who works for you, not an insurance company.

 

Editor’s Note:  This article was written by Crystal Manning, Licensed Medicare Advisor.  If you would like my consult at no cost to you, please contact me by phone at 412-716-4942 or by email at crystalmanning33@gmail.com

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Medicare Insurance 10008 Pine Ridge Drive, Wexford, Pennsylvania, 15090

As we approach retirement, one of the greatest concerns is determining the cost of health care. Health care will likely be your biggest expense during the golden years. Obviously, these costs are a tough number to nail down and one that will vary by person, but there are estimates available. Remove the fear, uncertainty, and costly mistakes from the Medicare enrollment process. Call for a one-to-one, no charge consultation.