Lowering Chronic Drug Costs for Seniors in Medicare Part D.
This bill aims to reduce out-of-pocket costs for chronic care drugs for Medicare Part D beneficiaries by changing how cost-sharing is calculated. Starting in 2025, patient costs for these specific medications will be based on the drug's actual net price, factoring in manufacturer rebates, which is expected to lower expenses for seniors. This change affects individuals relying on regular medication for conditions like diabetes or heart disease.
Key points
Effective January 1, 2025, cost-sharing for chronic care drugs under Medicare Part D must be based on the net price (after deducting manufacturer rebates).
This change applies to specific drug categories used for chronic conditions, such as certain blood glucose regulators, anticoagulants, and respiratory agents.
The goal is to ensure seniors' out-of-pocket expenses reflect the true cost of the medication to the insurance plan.
For low-income individuals, the copayment for chronic drugs cannot exceed the applicable cost-sharing under their specific plan.
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