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As of January 1, 2024, Part D enrollees are no longer required to pay 5% coinsurance after they reach the catastrophic threshold. According to a new KFF report, this means that in 2024, Part D enrollees will pay no more than about $3,300 for all brand-name drugs they take. And starting in 2025, out-of-pocket (OOP) drug spending will be capped at an even lower amount, $2,000, indexed annually for growth in Part D costs.
To illustrate the impact of this coinsurance change, KFF examined three commonly taken cancer drugs, each priced at well over $100,000 a year. In 2023, Medicare Part D enrollees who used any of these drugs for the entire year faced nearly $12,000 in OOP costs. In 2024, their portion will drop by eight to nine thousand dollars. And next year, when the $2,000 cap takes effect, they’ll save even more.
[EXTERNAL LINK] - Few Beneficiaries Know Part D Out-of-Pocket Cap Now in Effect - Medicare Rights Center
To illustrate the impact of this coinsurance change, KFF examined three commonly taken cancer drugs, each priced at well over $100,000 a year. In 2023, Medicare Part D enrollees who used any of these drugs for the entire year faced nearly $12,000 in OOP costs. In 2024, their portion will drop by eight to nine thousand dollars. And next year, when the $2,000 cap takes effect, they’ll save even more.
[EXTERNAL LINK] - Few Beneficiaries Know Part D Out-of-Pocket Cap Now in Effect - Medicare Rights Center