Q. My wife and I used to pay a $0 co-pay for our satin prescriptions, but when we turned 76 we had to pay a co-pay. Will this new inflation bill help?
— Hoping to save money
A. No one wants to pay a copayment for drugs if they don’t have to.
This is especially true for those on fixed incomes in these times of inflation.
There is still much to discover about the Cut Inflation Act of 2022 and whether it will help your specific situation.
Here are some things to consider about the law, which includes several provisions aimed at lowering prescription drug costs for people with Medicare and reducing federal drug spending.
Prices for a small number of single-source brands can be negotiated under Medicare Part D, starting in 2026, and under Part B, starting in 2028, said Evan Drury, licensed financial consultant. at US Financial Services in Fairfield.
Subject to price negotiation, 10 Part D drugs for 2026, 15 Part D drugs for 2027, 15 Part D and Part B drugs for 2028, 20 Part D and Part B drugs for 2029 and beyond, Drury said.
“These drugs will be selected from the 50 drugs with the highest Medicare Part D total spend and the 50 drugs with the highest Medicare Part B total spend,” he said. “The number of available negotiated price drugs will accumulate over time.”
Some drugs will be excluded from negotiations, he said. These include those that are generic and those that are less than nine years (for small molecule drugs) or 13 years (for biologics) from their date of FDA approval or clearance.
Additionally, so-called “small biotech drugs” will be excluded until 2029. These are defined as those that account for 1% or less of Part D or Part B expenditures and account for 80% or more of expenses of each party on this manufacturer. drugs, he said.
In addition, drugs with Medicare expenditures of less than $200 million in 2021, which will be increased by the CPI-U for subsequent years, will be excluded, along with all plasma-derived products, he said. he declares.
Also important to note: The Inflation Reduction Act requires drug manufacturers to pay a rebate to the federal government if the prices of single-source drugs and biologics covered by Medicare Part B disease and nearly all drugs covered by Part D are rising faster than the rate of inflation (CPI-U), Drury said.
But not all drugs will have discounts and it seems unclear which drugs will have discounts at present, he said.
Overall, the legislation allocates $160 million in funding over 10 years (2022-2031) to the Centers for Medicare & Medicaid Services (CMS) to implement inflation reimbursement provisions ($80 million). dollars for Part B and $80 million for Part D), he said. .
“The Part D inflation reimbursement provision comes into effect in 2022, the starting point for measuring drug price increases, with reimbursement payments required from 2023. Part B inflation takes effect in 2023,” he said.
Consider consulting a health insurance professional with any questions about this.
Send your questions to Ask@NJMoneyHelp.com.
Karin Price Mueller writes the Bamboos column for NJ Advance Media and is the founder of NJMoneyHelp.com. Follow NJMoneyHelp on Twitter @NJMoneyHelp. To find NJMoneyHelp on Facebook. Register for NJMoneyHelp.comit is weekly e-newsletter.