Medicare Part D Redesign Savings May Be Lower For Beneficiaries With Spending Below The Out-Of-Pocket Cap.

The Medicare prescription drug plan redesign under the Inflation Reduction Act of 2022 aims to simplify the Part D benefit while capping out-of-pocket spending for Part D--covered drugs. Whether and which Medicare beneficiaries will see savings from the redesigned benefit is unclear.We evaluated pla...

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Publicado en:Health Affairs Vol. 44; no. 6; pp. 650 - 659
Autores principales: Dusetzina, Stacie B., Kwon, Youngmin, Keating, Nancy L., Huskamp, Haiden A.
Formato: research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Medicare Part D Redesign Savings May Be Lower For Beneficiaries With Spending Below The Out-Of-Pocket Cap.
      aug:
        au:
          Dusetzina, Stacie B.
          Kwon, Youngmin
          Keating, Nancy L.
          Huskamp, Haiden A.
        affil: Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
      sug:
        subj:
          Medicare Legislation and Jurisprudence
          Insurance Coverage Evaluation
          Health Care Costs Evaluation
          Cost Savings
          Drugs, Prescription Economics
          Drugs, Generic Economics
          Human
          Descriptive Statistics
          United States
          Nonexperimental Studies
          Health Insurance Exchanges
          Comparative Studies
          Funding Source
      ab: The Medicare prescription drug plan redesign under the Inflation Reduction Act of 2022 aims to simplify the Part D benefit while capping out-of-pocket spending for Part D--covered drugs. Whether and which Medicare beneficiaries will see savings from the redesigned benefit is unclear.We evaluated plan coverage and cost sharing for commonly used brand-name and generic drugs to estimate potential out-of-pocket spending changes for beneficiaries using the same drug and plan in both 2024 and 2025. We found that beneficiaries filling prescriptions for high-cost drugs would have expected mean savings of approximately $1,400 between 2024 and 2005. Beneficiaries who had spending lower than the out-of-pocket cap of $2,000 would have less consistent savings as a result of plans increasing the use of coinsurance versus copayments for preferred brands and increases in premiums among some stand-alone Part D plans. The variability across plans in expected out-of-pocket spending and premiums under the redesigned drug benefit reinforces the need for Medicare beneficiaries to shop for plans that best match their expected medication use.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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