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Lower out-of-pocket drug costs
The Inflation Reduction Act reduces the cost of insulin and vaccines. These benefits apply regardless of your plan's drug tier and deductible.
$35 insulin cap
With the law, people with Medicare pay no more than $35 for a month’s supply of insulin. This applies to Medicare Part B and Part D insulins.
$0 vaccines
With the law, people with Medicare will pay nothing out-of-pocket for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). Some examples of vaccines covered include: RSV, shingles, and tetanus / diphtheria / pertussis.
Other changes include lower cost-share for some drugs and expanded access to premium help.
Catastrophic Phase
No copay for your prescriptions in the Catastrophic Phase
Medicare has a limit to what you have to pay out-of-pocket for your covered Part D drugs each year. Once you reach that limit, you enter the Medicare Catastrophic Phase. This means beginning January 1, 2024, once you reach the Catastrophic Phase, you'll pay nothing for your covered Part D drugs for the rest of the calendar year.
Extra Help
Check your eligibility for the “Extra Help” or low-income subsidy (LIS) program
People with Medicare who earn less than 150% of the federal poverty level are now eligible for the low-income subsidy (LIS) or “Extra Help” program. Everyone who qualifies for Extra Help will pay $0 in premiums, $0 in deductibles, and a lower cost for generic and brand-name drugs.
Part B drugs
Pay less for eligible Part B drugs
Drug companies that raise the prices of certain drugs faster than the rate of inflation are now required to pay Medicare a rebate. Those savings lower your cost-share for some Part B drugs. To learn more and find out if your drug is included, ask your pharmacist. These drugs may change each quarter. This change doesn’t apply to Part D drug coverage.
2025 Medicare changes
$2,000 Part D out-of-pocket maximum
Medicare Part D enrollees will have a $2,000 out-of-pocket maximum for annual prescription drug costs.
Prescription Payment Plan
Medicare Part D enrolless will have the option to pay their out-of-pocket prescription drug costs in monthly payments, spread over the year, rather than all at once.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working to make health care more affordable, easier to navigate, and accessible for all. That work includes ensuring Medicare enrollees have access to affordable prescriptions when they need them.
Disclosures:
Blue Cross and Blue Shield of North Carolina is an HMO, HMO-POS, PPO and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.
Blue Cross and Blue Shield of North Carolina Senior Health DBA Blue Cross and Blue Shield of North Carolina is an HMO-POS D-SNP plan with a Medicare contract and a NC State Medicaid Agency Contract (SMAC). Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal.
Blue Medicare Supplement plans offered: [Plan A: BMS A, 1/24, Plan G: BMS G, 1/24, Plan HI DED G: BMS HDG, 1/24, Plan K: BMS K, 1/24, Plan N: BMS N, 1/24.]
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Current as of 07/12/2024 | Y0079_12318_M CMS Accepted 08282024 | U36079, 6/24
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