How would a Medicare cap change your life?

Tell us how a $2,000 annual cap on your out-of-pocket medication costs would change your life, and help us show Congress that Medicare reform will make a difference!

Record a video expressing how an annual cap on your medication costs would change your life and upload it here, or write out your response to share below.

Step 1 of 2

Full name*
How would a $2,000 annual cap on your out-of-pocket medication costs change your life? Record a video response and upload it here.
Drop files here or

Accepted file types: jpg, gif, png, jpeg, mp4, mov, Max. file size: 50 MB, Max. files: 6.
Size limit for each file is 50 MB; maximum of 6 files.
If you would like to add more information about yourself or your response, please share below.
Email*
Phone number
State*

Please consent to our Terms and Conditions

Please read this carefully before you share your story and any personal information or media with us. By submitting information to the PAN Foundation and clicking “I agree,” you’re confirming that you have read, understand, and agree to the PAN Foundation’s Terms and Conditions as follows:
- You understand and agree that we may use your content for any informational, fundraising, or promotional purposes.
- You understand and agree that we can use and display any of your content and personal information that you provide in any format.
- You give us the right to verify the information you submit with other information we may have in our files.
- You give us the right to contact you for additional information if we think it would be helpful or necessary to do so.
- You understand and agree that you will not be paid or reimbursed in any way for your content or other information you provide to us.
- You consent to the use, distribution, and redistribution of your content and information by the PAN Foundation and its employees, contractors, and representatives.
- You understand and agree that you do not have the right to inspect or approve any finished product.
- You release and agree to indemnify and hold harmless the PAN Foundation, its employees, contractors, and representatives from any claims, lawsuits, injury and/or damages as a result of the content and information you provide to us.
This includes but is not limited to claims for personal injury (including injury to reputation), property damage, invasion of privacy and/or breach of confidentiality.
Download our Terms and Conditions (PDF 230KB)
Consent*
I agree with your terms and conditions*
I am interested in future opportunities to share my story with the PAN community
Phone
This field is for validation purposes and should be left unchanged.

How would a Medicare cap change your life?

Tell us how a $2,000 annual cap on your out-of-pocket medication costs would change your life, and help us show Congress that Medicare reform will make a difference!

Step 1 of 2

Please consent to our Terms and Conditions