What's New in Medicare

Inflation Reduction Act and Its Impact on Medicare in 2023

In August President Biden signed the Inflation Reduction Act of 2022. This Act includes measures that will directly impact Medicare beneficiaries.  This article will explain two of the measures that are already in place in 2023.

Capping the Price of Insulin

Some of the first changes are connected to insulin prices. This year for each prescribed insulin product you take, which is covered by your Part D Drug Plan, you will pay a co-pay of no more than $35 per month. So, if a person uses two insulins, and both are covered under their Part D Drug Plan, they would pay no more than $70 a month for insulin. It is important to understand that the insulin you use must be covered by your drug plan. If it is not included on the plan’s formulary (the list of drugs they cover) then it will not be limited to a $35 or less copay.

For persons using disposable “patch” pumps (a small wireless, tubeless pump worn directly on the body, for example, Insulet or Omnipod), the $35 per month’s supply copay limit will also be in place for any insulin covered by your Part D plan. However, the disposable pump itself does not have the $35 copay limit.

This $35 dollar limit also does not include drugs used to manage diabetes such as Trulicity, Bydureon, Mounjaro and Ozempic.

Cost Sharing for Adult Vaccines

A second change that went into effect this year is the elimination of cost sharing for adult vaccines covered under Medicare Part D. Vaccines that now have no cost sharing are ones that have been recommended by the CDC’s Advisory Committee on Immunization Practices. This will include shingles and tetanus vaccines.

Please note that the Inflation Reduction Act has provisions for changes that will go into effect from 2023 through 2029. Stay tuned via our upcoming newsletters to learn about those additional changes next year and beyond!