KFF Explains Medicare Changes That Can Help Reduce or Spread Prescription Drug Costs

KFF Answers Medicare Questions:

I heard there have been changes to Medicare in recent years to help beneficiaries lower their out-of-pocket prescription drug costs or spread them throughout the year. How can these changes help me?

Yes. Recent changes have improved the Part D benefit. Your annual Part D out-of-pocket spending is capped at $2,400. In addition, insulin cost sharing is capped at $35 a month for each prescription, and you no longer have to pay cost sharing for adult vaccines covered by your Part D plan, including the shingles vaccine.

Medicare Part D plans must also give enrollees the choice to pay their out-of-pocket drug costs through monthly installments over the year rather than all at once at the pharmacy. You can choose this payment arrangement, called the Medicare Prescription Payment Plan, by contacting your plan at any time. When you pick up a prescription, you will not pay the pharmacy; your drug plan will bill you each month instead. This option can make high drug costs easier to manage, but it does not lower your overall drug spending. Every Part D plan must offer the option, though enrollment is voluntary. For more information, contact your drug plan or visit its website. You can also reach your State Health Insurance Assistance Program (SHIP) for more information. SHIPs provide local, personalized counseling and assistance to people with Medicare and their families. Call 877-839-2675 to get the phone number for the SHIP in your state.

KFF Answers Medicare Questions: I Am Covered By Medicare, But I Don’t Take Any Medications. Do I Need To Sign Up For A Drug Plan?

While every effort has been made to provide accurate and current information in these FAQs, people should contact Medicare, Social Security, SHIP, or companies that offer Medicare Advantage, Medicare Part D plans, and Medigap policies directly for guidance on their own circumstances.

Source: KFF