There are a number of significant changes to the Medicare Part D prescription drug benefit (which includes Medicare Advantage plans that offer Part D coverage) that are taking effect in 2025. The Center for Medicare Advocacy and the PAN Foundation recently reviewed these changes in a webinar, the recording of which is now available. Despite the significance of these changes, awareness of them is limited. There are a number of resources available to help inform and educate about these changes.
Center for Medicare Advocacy and PAN Webinar – Recording Available
On September 17, 2024, the Center for Medicare Advocacy joined the PAN Foundation in presenting a webinar titled “Understanding the Changes in Medicare Part D for 2025.” A recording of the webinar is available here.
Among other things, the webinar addressed the Medicare prescription drug changes pursuant to the Inflation Reduction Act of 2022 (IRA), including the $2,000 out-of-pocket cap for Part D drugs starting in 2025, as well as the Medicare Prescription Payment Plan (MPPP) that allows Part D enrollees to spread their cost over the course of the year rather than having to pay costs all at once. As noted and linked below, the Medicare program recently released new materials in multiple languages about the MPPP.
Awareness of Drug Law Changes Remains Limited
During the webinar, PAN presented the results of a national Medicare Reforms Awareness Survey that the Foundation conducted in June 2024, the results of which will be released soon. In short, the survey found that there is little awareness or understanding of these Part D changes, reflecting a real need for further education of the public.
Similarly, KFF recently released a report titled “KFF Health Tracking Poll September 2024: Support for Reducing Prescription Drug Prices Remains High, Even As Awareness of IRA Provisions Lags” (Sept. 13, 2024). Among other things, KFF found “widespread support” for Medicare drug price negotiations, but “[m]ost voters continue to be unaware of the Medicare drug pricing provisions in the Inflation Reduction Act […]”
Additional Resources re: Part D Changes
- PAN Foundation: https://www.panfoundation.org/everything-you-need-to-know-about-medicare-reforms/
- Centers for Medicare & Medicaid Services (CMS)
- Department of Health & Human Services (HHS):
- KFF (Kaiser Family Foundation):
- FAQs address several questions related to Medicare’s drug price negotiation program and how CMS is implementing it, with a focus on the details for 2026, the first year that negotiated prices will be in effect.
- Three charts explain key elements of the drug negotiations process and what it means for Medicare beneficiaries, the timetable, and the public’s views about requiring the government to negotiate drug prices.
- An explainer summarizes the provisions in the Inflation Reduction Act that will lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. It also examines the expected effects on people, program spending, and drug prices and innovation.
- A new analysis looks at how many people with employer-sponsored insurance use the drugs slated for Medicare price negotiations.
- Key KFF polling findings explore the public’s experience with, and perceptions of, prescription drugs and their prices.
New Medicare Resources re: Medicare Prescription Payment Plan (MPPP)
The Medicare agency (CMS) continues to release information about these Part D changes, including materials about the Medicare Prescription Payment Plan, on the www.medicare.gov website here.
On September 9, 2024, CMS announced that it is “developing a cost preview inside of the Medicare Plan Finder that’s based on a consumer’s specific drug list, a set of consumer-selected Medicare Advantage or Part D plans, and consumer-selected pharmacies, including both retail locations and mail order options. Part D sponsors can encourage consumers to visit Medicare Plan Finder and enter their drugs and the plan they have (or want to switch to) to get an estimate of monthly costs with and without this payment option. The cost preview will be available in time for open enrollment in the fall.”
In addition, CMS recently released fact sheets and other public-facing resources related to the Medicare Prescription Payment Plan in English, Spanish, Chinese, Korean, and Vietnamese:
- English: https://www.medicare.gov/publications/12211-whats-the-medicare-prescription-payment-plan.pdf
- Spanish: https://www.medicare.gov/publications/12211-s-whats-the-medicare-prescription-payment-plan.pdf
- Chinese: https://www.medicare.gov/publications/12211-c-whats-the-medicare-prescription-payment-plan.pdf
- Korean: https://www.medicare.gov/publications/12211-k-whats-the-medicare-prescription-payment-plan.pdf
- Vietnamese: https://www.medicare.gov/publications/12211-v-whats-the-medicare-prescription-payment-plan.pdf.pdf
CMS also posted a “takeaway card”:
- English: https://www.medicare.gov/publications/12212-manage-your-monthly-drug-costs.pdf
- Spanish: https://www.medicare.gov/publications/12212-s-manage-your-monthly-drug-costs.pdf
- Chinese: https://www.medicare.gov/publications/12212-c-manage-your-monthly-drug-costs.pdf
- Korean: https://www.medicare.gov/publications/12212-k-manage-your-monthly-drug-costs.pdf
- Vietnamese: https://www.medicare.gov/publications/12212-v-manage-your-monthly-drug-costs.pdf
September 19, 2024 – D. Lipschutz