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

In accordance with the 2022 Inflation Reduction Act, beginning in 2025 people with Medicare Part D plans have an annual cap on their out-of-pocket prescription medication costs.

Learn more: Understanding the Medicare Part D cap

PAN’S POSITION

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

The PAN Foundation is proud to have been a leading voice over the past 10 years advocating for and championing this reform. Through our efforts, we urged Congress and the Centers for Medicare & Medicaid Services to set a limit on the amount Medicare beneficiaries must spend out-of-pocket on prescription drugs.

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

Why is a cap needed for Medicare Part D?

Until this reform went into effect, Medicare beneficiaries were 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 skip treatment altogether.

Without this cap, some patients who require expensive but life-saving medications have incurred thousands of dollars throughout the year in out-of-pocket costs for their prescriptions.

Now that the Medicare Part D cap is in place, the PAN Foundation continues to serve as a key resource when it comes to increasing awareness, offering educational resources, and conducting research about this reform.