Saving money with the prescription drug law (2024)

More vaccines covered

People with Medicare Part D drug coverage now pay nothing out-of-pocket for even more vaccines. Your Part D plan won't charge you a copayment or apply a deductible for vaccines that the Advisory Committee on Immunization Practices recommends, including the vaccines for shingles, whooping cough, and more.

Lower costs for insulin

Part D insulin costs

Your Medicare drug plan can't charge you more than $35 for a one-month supply of each Part D-covered insulin,and you don’t have to pay a deductible. You’ll pay $35 (or less) for a one-month supply of each Part D-covered insulin product, even if you get Extra Help to lower your prescription drug costs.

If you get a 3-month supply of insulin, your costs can’t be more than $105 ($35 for each month’s supply).

Other questions about insulin coverage under Part D?

Part B insulin costs

If you use an insulin pump that’s covered under Part B’s durable medical equipment benefit, or you get your covered insulin through a Medicare Advantage Plan, your cost for a month’s supply of Part B-covered insulin can’t be more than $35. The Part B deductible won’t apply. If you have Part B and Medicare Supplement Insurance ( Medigap) that pays your Part B coinsurance, your plan should cover the $35 (or less) cost for insulin.

If you get a 3-month supply of insulin, you'll generally pay no more than $105, because your costs can’t be more than $35 for each month’s supply of each covered insulin.

Get more information about this new insulin benefit.

Learn more about insulin costs.

Lower out-of-pocket drug costs

  • You might pay a lower coinsurance amount for certain drugs and biologicals covered by Part B, if their prices have increased higher than the rate of inflation. The specific drugs and potential savings change every quarter.
  • If you have drug costs high enough to reach the catastrophic coverage phase in your Medicare drug coverage, you won’t have to pay a copayment or coinsurance, starting in 2024.
  • Extra Help affording prescription drug coverage (the Part D Low-Income Subsidy (LIS) program) will expand to cover more drug costsforpeople with limited resources who earn less than 150% of the federal poverty level, starting in 2024. People who qualify for Extra Help generally will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.
  • Your yearly Part D out-of-pocket costs will be capped at $2,000, starting in 2025. You’ll also have the option to pay out-of-pocket costs in monthly amounts over the plan year, instead of when they happen.
  • If the price of a drug covered by Part B (Medical Insurance) increased faster than the rate of inflation, you might pay less than 20% coinsurance for that drug. The specific drugs that are impacted and the potential savings may change every quarter.Get more information about Part B-covered drugs.

Medicare will negotiate to get you lower drug prices

For the first time, Medicare will be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don’t have competition.

  • The first 10 drugs selected for negotiation are:
    • Eliquis
    • Jardiance
    • Xarelto
    • Januvia
    • Farxiga
    • Entresto
    • Enbrel
    • Imbruvica
    • Stelara
    • Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill
  • Negotiated prices for these first 10 drugs will be effective in 2026.
  • In the future, Medicare will select and negotiate costs for:
    • 15 Part D drugs in 2025 (effective in 2027).
    • 15 Part B and Part D drugs in 2026 (effective in 2028).
    • 20 Part B and Part D drugs in 2027 (effective in 2029).
    • 20 Part B and Part D drugs in 2028 and every year after.
  • Manufacturers that don’t follow the negotiation requirements will have to pay a tax, and will have to pay penalties if they don’t fulfill other manufacturer requirements.
Saving money with the prescription drug law (2024)


Did the prescription bill pass? ›

President Biden's prescription drug law, the Inflation Reduction Act, was signed into law on August 16, 2022.

What is the maximum out-of-pocket for Medicare Part D in 2024? ›

In response to the new Medicare Part D reform that will place a cap of around $3,300 on prescription out-of-pocket costs for all Medicare Part D drugs starting in 2024, we are adjusting our grant amounts beginning on January 1, 2024.

Can you save money on prescriptions? ›

A PPC could save you money if you pay for your NHS prescriptions. The certificate covers all your NHS prescriptions for a set price. You will save money if you need more than 3 items in 3 months, or 11 items in 12 months.

Is the Medicare donut hole going away in 2024? ›

In the donut hole, you pay up to 25% out of pocket for all covered medications. You leave the donut hole once you've spent $8,000 out of pocket for covered drugs in 2024. 2024 is the last year for the donut hole. A $2,000 out-of-pocket cap takes effect for Medicare Part D in 2025.

What are the changes to Part D in 2024? ›

In 2024, a Smaller Number of Part D Stand-Alone Drug Plans Will Be Premium-Free to Enrollees Receiving the Low-Income Subsidy Than in Any Year Since Part D Started. Through the Part D LIS program, enrollees with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing.

How much will the Medicare Part D plan cost in 2024? ›

If you have a Medicare Part D plan you may pay premiums, deductibles, copayments, and/or coinsurance for your prescription coverage. The average monthly premium for a Part D plan is projected to be $55.50 in 2024, though plans vary.

Can I use GoodRx if I'm in the donut hole? ›

Stuck in the donut hole? If you reach the coverage gap and can't afford your medications, look up discounts for those medications on GoodRx. There's a good chance you can save a significant amount in the long run, especially if you know you won't be able to meet the $8,000 out-of-pocket maximum.

Can I buy a stand-alone prescription drug plan? ›

Prescription drug insurance is available as a stand-alone plan. It works similarly to medical insurance: You pay an annual premium and then have a copay or coinsurance cost at the pharmacy. The most well-known type of stand-alone plan is Medicare Part D, though privately-run plans do exist.

What is the donut hole for 2024? ›

The Medicare Part D donut hole or coverage gap is the phase of Part D coverage after your initial coverage period. You enter the donut hole when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit. In 2024, that limit is $5,030.

How not to pay for prescription? ›

have a specified medical condition and have a valid medical exemption certificate (MedEx) – your doctor will give you an application form. have a continuing physical disability that prevents you going out without help from another person and have a valid medical exemption certificate (MedEx)

What is the cheapest pharmacy? ›

In the Consumer Reports survey, Costco had the best prices for a brick-and-mortar store, while the online mail-order pharmacy had the lowest overall pricing. The report found the two highest-priced national retailers were CVS Health and K-Mart for the common medications they checked.

Do diabetics get free prescriptions? ›

How to get free prescriptions for diabetes medicine. If you take diabetes medicine, you're entitled to free prescriptions for all your medicines, including medicines for other conditions. To claim your free prescriptions, you'll need to apply for an exemption certificate.

How do you get into the donut hole in Medicare? ›

The Medicare donut hole is another name for what is sometimes called the Medicare Part D coverage gap. You enter the donut hole when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit beyond your initial coverage period threshold.

What happens to the donut hole in 2025? ›

Elimination of Coverage Gap Phase: The coverage gap phase, where enrollees faced 100% of their drug costs, will be eliminated in 2025. Enrollees will no longer experience a change in their cost sharing when transitioning from the initial coverage phase.

How to avoid the doughnut hole? ›

Choosing generic medications whenever possible can help keep prescription drug costs lower and slow down the progression into the Donut Hole.

When was the Medicare prescription drug bill passed? ›

In 2003, Congress signed into law the Medicare Prescription Drug, Improvement and Modernization Act. This law includes a prescription drug benefit called Medicare Part D. This new law makes prescription drug coverage available to all Medicare beneficiaries beginning January 1, 2006.

Have we got to pay for prescriptions? ›

Prescription charges are for each item not each prescription. For example, if your prescription has 3 medicines on it you will have to pay the prescription charge 3 times. Some items are always free, including contraception and medicines prescribed for hospital inpatients.

When was the Prescription Drug Marketing Act passed? ›

The Prescription Drug Marketing Act of 1987 (PDMA) was signed into law by the President on April 22, 1988.

What healthcare bill was passed by Congress? ›

All legislative power in the government is vested in Congress, meaning that it is the only part of the government that can make new laws or change existing laws. Executive Branch agencies issue regulations with the full force of law, but these are only under the authority of laws enacted by Congress.

Top Articles
Latest Posts
Article information

Author: Jonah Leffler

Last Updated:

Views: 5875

Rating: 4.4 / 5 (45 voted)

Reviews: 84% of readers found this page helpful

Author information

Name: Jonah Leffler

Birthday: 1997-10-27

Address: 8987 Kieth Ports, Luettgenland, CT 54657-9808

Phone: +2611128251586

Job: Mining Supervisor

Hobby: Worldbuilding, Electronics, Amateur radio, Skiing, Cycling, Jogging, Taxidermy

Introduction: My name is Jonah Leffler, I am a determined, faithful, outstanding, inexpensive, cheerful, determined, smiling person who loves writing and wants to share my knowledge and understanding with you.