Thanks to the Inflation Reduction Act, Medicare enrollees may pay less for certain Part B drugs. If you ever have drugs administered at the doctor or hospital outpatient setting, this could save you money.
What Are Medicare Part B Drugs
Most people have heard of Medicare Part D drugs for prescription coverage at the pharmacy. Medicare Part B drugs are different. Part B covers drugs you wouldn’t typically give to yourself, like those you get at a doctor’s office, a hospital outpatient setting, or drugs for use with covered durable medical equipment. These drugs are often, but not always, injectables. (Source). Those who do not have a Medigap plan that covers Medicare Coinsurance, often have to pay 20% of the cost of Part B drugs.
Note: Learn about new big savings for Medicare Part D drugs you usually get at the pharmacy here.
Reducing Medicare Part B Drug Costs
The U.S. Department of Health and Human Services (HHS), alongside the Centers for Medicare & Medicaid Services (CMS), has announced that 41 drugs under Medicare Part B will see a reduced coinsurance rate between April 1 and June 30, 2024. This adjustment comes into effect if drug prices increase faster than the inflation rate.
Under the Inflation Reduction Act, drug companies are mandated to reimburse Medicare for certain drugs if their prices escalate beyond the inflation rate. CMS plans to start invoicing drug companies for owed rebates by fall 2025. The rebate funds from drug companies will be channeled into the Federal Supplementary Medical Insurance Trust Fund. This measure aims to ensure the long-term sustainability of the Medicare program for future generations.
Impact of the Inflation Reduction Act on Your Drug Savings
Under the new Medicare Prescription Drug Inflation Rebate Program, Medicare could save significant amounts, ranging from $1 to $3,575 per average dose, depending on their coverage. Approximately 763,700 Medicare beneficiaries use these drugs annually, meaning over half a million Americans will benefit from this initiative (Source – Centers for Medicare & Medicaid Services).
If you are on Medicare and take one of the drugs below, this could save you money since you may only have to pay 20% of the new discounted cost of the drugs. Remember that if you purchase Medigap, your insurance could pay the 20% for you. As an added benefit, any savings Medicare receives will go back to help fund Medicare in the future.
Prescriptions Drugs: List of Impacted Medications
Below is the list of drugs with adjusted coinsurance amounts for the quarter April 1 – June 30, 2024:
| Short Description | Inflation-Adjusted Coinsurance Percentage |
|---|---|
| Abelcet | 19.92% |
| Adcetris | 19.29% |
| Akynzeo Capsule | 18.20% |
| Akynzeo IV | 19.73% |
| Argatroban (Accord) | 16.76% |
| Argatroban (Auromedics) | 7.47% |
| Atgam | 15.37% |
| Aveed | 19.14% |
| Bicillin C-R | 16.31% |
| Bicillin L-A | 16.25% |
| Blincyto | 19.79% |
| Chirhostim | 19.60% |
| Crysvita | 19.38% |
| Cytogam | 19.78% |
| Dysport | 18.88% |
| Envarsus Xr | 19.94% |
| Fosaprepitant (Teva) | 3.82% |
| Fragmin | 12.23% |
| Hypertet | 19.67% |
| Imlygic | 19.90% |
| Kepivance | 16.56% |
| Kymriah | 19.31%t |
| Leukine | 19.59% |
| Lupron Depot Ped | 19.51% |
| Meropenem (B Braun) | 9.54% |
| Minocin | 19.09% |
| Nexterone (Baxter) | 11.54% |
| Nipent | 19.85% |
| Oncaspar | 19.66% |
| Padcev | 18.89% |
| Panhematin | 19.84% |
| Prolia | 19.59% |
| Romidepsin (non-lyophilized) | 19.79% |
| Signifor LAR | 17.85% |
| Sotalol (Altathera) | 19.97% |
| Sylvant | 18.95% |
| Synribo | 19.70% |
| Tigan | 19.72% |
| Tigecycline (Accord) | 8.83% |
| Tivdak | 19.85% |
| Vabomere | 19.81% |
| Xiaflex | 18.56% |
| Zemdri | 19.91% |
See the full table, including the HCPCS codes, in this CMS release.
If you want to learn more about Medigap plans to cover your Part B expenses or Medigap Part D drug coverage, give Senior65.com a call at 800-930-7956.