Caps on insulin costs and free shingles vaccinations come with new year

Dec 27th, 2022 | By | Category: Health & Fitness

Beginning in 2023, two measures in the federal Inflation Reduction Act will take effect with a goal of lowering healthcare costs for older Americans on Medicare. Effective Jan. 1, they can be vaccinated for shingles for free, and millions will pay no more than $35 per month on insulin.

About 3 million insulin users who have Medicare Part D will benefit from the cap on insulin costs, and the free shingles vaccinations will be available to nearly 64 million Medicare beneficiaries.

Specifically, according to Medicare, the lower drug costs and improved Part D coverage mean:

  • The cost of a month’s supply of each Part D-covered insulin will be capped at $35, and there will be no deductible for insulin. The cap applies to 60-day and 90-day supplies of insulinTtraditional insulin pumps that are covered under Medicare’s durable medical equipment benefit will now be covered under Medicare Part B.
  • Beneficiaries whose drug costs high reach the catastrophic coverage phase in their Medicare coverage won’t have co-payment or co-insurance costs, starting in 2024.
  • Extra Help affording prescription drug coverage (the Part D Low-Income Subsidy (LIS) program) will expand to certain people with limited resources who earn less than 150 percent of the federal poverty level, starting in 2024.
  • Yearly Part D out-of-pocket costs will be capped at $2,000, starting in 2025. And beneficiaries will have the option to pay out-of-pocket costs in monthly amounts over the plan year, instead of when they happen.
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