Seniors’ drug costs are about to be slashed — here’s what you need to know

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(BPT) - Today, Medicare beneficiaries across the country face a devastating predicament: Often, they can manage serious conditions like cancer by taking daily prescription drugs — but there’s no limit to what they might owe for the drugs that keep them alive.

In many cases, this puts the treatment out of reach — or patients have to make immense sacrifices to pay for it.

Sharon Clark, a blood cancer patient in Oklahoma, has a story that’s all too common among those facing chronic health conditions. She went months without taking her lifesaving drugs because she could not afford them, despite being covered by Medicare Part D, which was designed to help cover the cost of prescription drugs. She’s not alone: Many Medicare patients are forced to spend $10,000 or more out-of-pocket each year on prescription drugs.

Out-of-pocket costs refer to the amount that patients pay for their health care, including deductibles, coinsurance and copayments. For many, these costs are too high; more than four in 10 Medicare enrollees abandon their cancer treatment when it costs them more than $2,000.

Soon, stories like Sharon’s will be history, thanks to the newly enacted Inflation Reduction Act, which will make it easier for older adults and those with disabilities to afford their medications. Here are the changes Medicare beneficiaries can expect – and when.

  • Patients covered by Medicare won’t be required to pay for most vaccines they receive through the Part D benefit, starting Jan. 1, 2023.
  • Insulin co-pays for those covered by Medicare will be capped at $35 per month — regardless of whether the patient has met their deductible, starting Jan. 1, 2023.
  • Beginning in January 2024, Medicare beneficiaries’ out-of-pocket costs for drugs purchased with their Part D coverage will be capped at around $3,400.
  • Beginning in January 2025, Medicare beneficiaries’ out-of-pocket costs for drugs purchased with their Part D coverage will be limited to $2,000 — regardless of how many drugs they take.

“It’s hard to overstate the value to blood cancer patients of these landmark health care reforms,” said Brian Connell, LLS executive director of federal affairs. “Half of all blood cancer patients are diagnosed while covered by Medicare, and they finally have the security of knowing their treatment should never be out of reach.”

The Leukemia & Lymphoma Society and blood cancer advocates spent nearly a decade urging lawmakers to cap Medicare patients’ drug costs. Those volunteers dedicated their time to ensuring lawmakers understand what cancer patients face — and what policy solutions could ease their burdens.

In the last two years alone, blood cancer advocates held hundreds of meetings with members of Congress and sent nearly 25,000 letters urging lawmakers to fix this issue. Their voices were heard.

Your voice can make a difference, too. If you want to support the next groundbreaking healthcare reform, sign up to become an advocate today by visiting lls.org/raiseyourvoice. You’ll get to choose how involved you’d like to be, and The Leukemia & Lymphoma Society will let you know when and how you can send messages to your lawmakers about these issues.