Place a limit on out-of-pocket costs in Medicare Part D

PAN’s POSITION

Out-of-pocket costs for prescription medications should be capped by instituting monthly or annual limits. 

In accordance with the Inflation Reduction Act, signed into law in August 2022, people with Medicare Part D prescription drug plans will not pay more than $2,000 per year for their medications beginning in 2025.

Congress and the Centers for Medicare and Medicaid Services should set a limit on the amount Medicare beneficiaries must spend out-of-pocket on prescription drugs.  

A monthly or annual cap would facilitate access to needed treatments, protect patients from high out-of-pocket costs, and help beneficiaries predict and plan for these costs throughout the year. 

Why a cap is needed in Medicare Part D

Medicare beneficiaries are the only group of insured people in the U.S. that is not protected by a cap on annual out-of-pocket costs, forcing many to make difficult trade-offs or to forgo treatment altogether. 

Some patients who require expensive but life-saving medications can incur thousands of dollars throughout the year in out-of-pocket costs for their prescriptions.

My co-pays are out of this world. Something has to be done about it.

Joan Durnell Powell, California, living with myelodysplastic syndrome