The
Inflation Reduction Act of 2022, H.R. 5376, is designed to reduce the deficit and lower inflation while investing in domestic energy and lowering Healthcare drug costs. It passed through the Senate and the House of Representatives in mid-August and is slated to be signed into law by President Biden. It is in essence, a scaled down version of the President’s “Build back Better” Act that was proposed by President Biden in 2021.
According to Senate Democrats, the proposed Legislation will raise $725 billion, require total investments of $433 billion and result in a reduction of more than $292 billion over 10 years. As with most legislation out of Washington, the bill contains reems of pages. The following is a condensed summary of its effect on Medicare beneficiaries.
Here are some of the highlights.
Starting in 2023, Medicare beneficiaries will have no deductibles, no co-insurance or other cost sharing requirements for any Adult vaccines covered through Medicare Part-D. Monthly out-of-pocket costs for covered Insulin products will now be capped at $35.00 per month.
2024
The subsidy for Medicare low-income beneficiaries participating in the LIS program will increase from 135% to 150% of the poverty level. The LIS program (Low Income Subsidy) is known as extra help. Depending on the level of enrollment of the member, the program provides cost assistance to co-pays on meds, Dr. and hospital visits, and Part-B premiums. The new law will add an estimated 400,000 Seniors to the program. The 5% co-pay that the member pays when entering the “Catastrophic Coverage phase” of Part-D (when out of pocket co-pays reach $7050 in 2022) is no longer required. Part-D out-of-pockets are capped at $7050 for the year. The new legislation will limit Part-D premium increases to no more than 6% per year from 2024 through 2029. This is designed to ensure that premiums do not outpace inflation.
2025
The Part-D out-of-pocket co-pays are now limited to $2000 for the year. This is the first year that Medicare will be allowed to negotiate the cost of Part-D medications. This element of the legislation will have 4 phases.
Phase 1, negotiate the cost of the 10 most expensive Pt-D meds for 2026.
Phase 2, negotiate the cost of the 15 most expensive Pt-D meds for 2027.
Phase 3, negotiate the cost of the 15 most expensive Pt-B and Pt-D meds for 2028.
Phase 4, negotiate the cost of the 20 most expensive Pt-B and Pt-D meds for 2029.
There is an
Inflation Rebate included in this Bill. As previously stated, negotiations will not effect medications until 2026. This legislation will penalize Pharmaceutical companies for raising Medicare drug pricing faster than the rate of inflation. Drug companies would have to pay the government the difference between the prices charges and the inflation rate for all Medicare sales of that drug.
There are elements to the Inflation Reduction Act of 2022 not mentioned here, and of course many people wanted more and some others felt the Legislation has gone too far. To the dismay of many there are no provisions for Dental or Hearing coverage as many would have preferred. The good news is that these benefits are available on some existing plan offerings, every Medicare beneficiary is eligible to benefit from this new bill. There are no restrictions on income attached to this bill.
These changes can be confusing. It helps to have a professional who can guide you through these differences. If you are not sure how this new legislation will affect your Medicare coverage, feel free to contact me directly at:
Mark Lee.
Office (860)367-9145
Email marklee@markleeandassociates.com
Licensed Insurance Professional. Respond and learn how financial products, including life insurance and annuities can be used in various planning strategies for retirement.
This material has been provided by a licensed insurance professional for informational and educational purposes only and is not endorsed or affiliated with the Social Security Administration or any government agency. It is not intended to provide, and should not be relied upon for, accounting, legal, tax or investment advice. 21169 - 2021/7/13