Lower Drug Costs for Seniors: Limiting Medicare Part D Copayments to Net Price.
This law aims to reduce prescription drug costs for individuals enrolled in Medicare Part D. Starting in 2026, patient cost-sharing (copayments) will be calculated based on the drug's true cost, after all rebates and discounts received by the insurer are deducted. This ensures seniors do not pay more than the actual net price of the drug for their insurance plan, directly reducing their out-of-pocket expenses.
Key points
Limits on drug cost-sharing under Medicare Part D (prescription drugs) take effect on January 1, 2026.
The patient's out-of-pocket cost cannot exceed the drug price minus manufacturer rebates (the net price).
This change is intended to directly reduce out-of-pocket expenses for millions of seniors on medication by basing their payments on the plan's actual lower cost.
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