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

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.

PAN’S POSITION

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

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