January 05, 2024

Lower Insulin Prices, Out-of-Pocket Cost Caps for Medicare Beneficiaries Kick Off 2024

Medicare beneficiaries will see a wide array of cost-saving benefits in the new year. Thanks to the Biden Administration, seniors will continue to pay no more than the monthly cap of $35 for insulin, and vaccines under Part D will be free.

Going forward, if a beneficiary’s drug costs are high enough to reach the catastrophic coverage phase, they will not have to pay coinsurance or make copayments. This effectively caps out-of-pocket expenses at $3,250 in 2024.

Another major change this year is the Part D Low-Income Subsidy program, Extra Help, which will now cover more drug costs for those who earn less than 150% of the federal poverty level. Qualifiers for the program will pay no more than $4.50 for generic drugs and $11.20 for brand-name drugs.

These 2024 benefits are only a few of the annually unrolling policies that are aimed at limiting Medicare costs under the Inflation Reduction Act that President Biden signed in 2022. Last year, drug companies were forced to participate in price negotiations with Medicare, which will lead to lower prices, and in 2025, the annual Part D out-of-pocket cap will be lowered to $2,000.

“Beginning with insulin, seniors are finally seeing the affordable prices they deserve for live-saving drugs,” said Richard Fiesta, Executive Director of the Alliance. “These changes in 2024 are important steps toward curbing drug corporation greed.”