Ask Congress to lower out-of-pocket costs

No one should be forced to choose between food or medicine.

Medicare Part D provides drug coverage to 45 million older adults and people with disabilities. And yet, Medicare beneficiaries are the only insured group in the U.S. without a cap on their annual out-of-pocket costs.

 

In addition, Medicare beneficiaries are burdened with high out-of-pocket costs at the beginning of each year when deductibles reset.

 

For many,  deductibles, co-pays, and coinsurance are unaffordable. Without a limit on out-of-pocket costs, millions of patients will continue to struggle to fill their prescriptions and maintain their health.

                                    
                                    

It was so scary, not knowing if I was going to be able to afford my cancer treatment.

Bill McMahon, Pennsylvania

At PAN, we know out-of-pocket costs are out of control. Join us to advocate for limits to out-of-pocket costs for Medicare Part D patients like Bill.

The problem

More than 45 million older adults and people with disabilities are enrolled in Medicare Part D. But their access to care is often impeded by cost sharing, which are healthcare expenses not covered by insurance that must be paid out of pocket. These expenses include deductibles, co-payments, and coinsurance.

Research shows that patients with serious illnesses are less likely to fill their medications when they encounter high out-of-pocket medication costs. These same patients also take longer to start their treatment and experience frequent, and often critical, interruptions in care.

Here’s the thing: There is already bipartisan support in the House, Senate, and White House to place an annual or monthly cap on out-of-pocket costs and to allow expenses to be spread out over the course of the year.

If you struggle with high out-of-pocket costs for prescription medications, or know or care for someone who does, your elected officials should hear from you. We need legislative action, now!

High costs have consequences

30%

of American adults have to choose between basic needs and paying medical bills.

43%

of patients in poor health struggle to pay for their medications.

58%

of Americans have delayed or gone without essential medical care due to cost.

Policy solutions

The PAN Foundation advocates for two key policy solutions that will modernize Medicare Part D, offer improved access to healthcare for 45 million people, and lower out-of-pocket costs. We advocate for:

  • An annual cap on out-of-pocket prescription medication costs to protect older adults and people with disabilities, particularly those on fixed incomes.
  • Evenly distributing out-of-pocket prescription medication costs throughout the year to help patients better anticipate and plan for their medication expenses—instead of paying extraordinary sums at the beginning of each calendar year.

Members of Congress in both parties support lowering out-of-pocket prescription medication costs for Medicare beneficiaries—but legislation has yet to be passed.

Advocate for action by using our form to contact your elected officials in Congress to share your story with our two policy recommendations. It’s time for Congress to stop delaying and start taking your healthcare seriously.

How you can help

First, know that you are not alone. In 2019, more than 45 million older Americans and people with disabilities enrolled in Medicare Part D.

Lynn Estep, 73, from Indiana had heard that medications for people with chronic diseases could be outrageously expensive. But she didn’t truly understand how extreme the out-of-pocket costs actually were until she was diagnosed with Parkinson’s disease.

“It was a roller coaster ride through one prescription after another trying to find drugs that would work to control my symptoms,” Lynn said. “Each new prescription would eat through our savings until there was nothing left.”

If you or a loved one face unmanageable out-of-pocket costs for prescription medications on Medicare Part D, reach out to your elected officials in Congress to share your story and demand relief. The form above will connect to your representatives and populate a letter, which you can customize and send without leaving our website.  

Send a message to your elected officials with the form above to ask for lower out-of-pocket costs