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FACT SHEET: Medicare Open Enrollment Brings New Benefits and Savings for Millions of Seniors

By October 23, 2023No Comments

Seniors Will Save in 2024 Thanks to the Inflation Reduction Act: Lower Drug Costs, Monthly Insulin Cost Cap, and Free Vaccines 

Medicare open enrollment began on October 15 and runs through December 7. Millions of seniors will begin selecting their coverage for 2024. It is important that seniors understand the savings available to them as they make decisions about enrolling in a Medicare plan.

As Medicare beneficiaries review plans for 2024, seniors will see new benefits thanks to the Inflation Reduction Act’s measures to drive down drug costs. As they did during the 2023 Medicare open enrollment, seniors will see lower premiums for prescription drug coverage. As of January 1, 2023, critical vaccines are now free, monthly insulin costs are capped at $35 per prescription, and drug companies cannot take advantage of seniors by raising drug prices faster than the rate of inflation. Additionally, in the years ahead, Medicare beneficiaries will see lower drug prices across the board thanks to the Inflation Reduction Act’s provisions to give Medicare the power to negotiate and cap out-of-pocket drug costs at $2,000 a year. This translates to thousands of dollars in savings for millions of seniors and people with disabilities nationwide. 

BY THE NUMBERS: Seniors Will Pay Less for Health Care

The Inflation Reduction Act is drastically reducing the cost of prescription drugs for the more than 50 million Americans enrolled in Medicare’s Part D drug benefit, reducing racial, income, and geographic disparities in health care, and saving lives. Seniors will no longer have to choose between paying for the drugs they need and other essentials like food and housing.

By the Numbers:

  • Over 50 million Medicare beneficiaries no longer face big drug companies’ outrageous price hikes that exceed inflation. 
  • All Medicare Part D beneficiaries have access to covered vaccines, such as shingles and pneumonia, at no cost.
  • No Medicare beneficiary pays more than $35 a month for an insulin copay.
  • Over 50 million Medicare Part D beneficiaries will have out-of-pocket costs for prescription drugs capped at $2,000 per year beginning in 2025. 
  • Lower prices are being negotiated for the first 10 drugs selected for the Negotiation Program, with more drugs to be named each year. The first ten drugs are Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/NovoLog.
  • Premiums for the average Medicare Part D plan are decreasing by 1.8 percent in 2024.

The Inflation Reduction Act Lowers Prescription Drug Prices

Medicare Negotiation For Lower Drug Prices. The Biden administration is implementing the Medicare Drug Price Negotiation Program which is supported by over 80 percent of Americans — the most popular provision in the Inflation Reduction Act. In August, the first round of high-cost drugs that will be negotiated was announced: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/ NovoLog. These high-cost drugs treat conditions like cancer, diabetes, and blood clots. The first ten drugs selected for negotiation are taken by nearly 9 million people on Medicare, who spent $3.4 billion in out-of-pocket costs last year alone.  The negotiated prices will be effective starting in 2026. 

Game-Changer For Insulin-Dependent Seniors. In 2020, there were more than 3.2 million insulin users with Medicare, with nearly 1.7 million purchasing their insulin without low-income subsidies. On average, seniors with Medicare Part D or B who are not receiving subsidies pay an average of $572 every year for this life-saving medication — an unthinkable sum for many on fixed incomes. Patients who suffer chronic complications can expect to pay upwards of an additional $650 per year. Under the Inflation Reduction Act, insulin copays for people on Medicare are capped at $35 per prescription each month. A recent study showed that 1.5 million people on Medicare would have saved an average of $500 in 2020 from the $35 insulin copay cap.

Ends Outrageous Price Increases For Seniors. The Inflation Reduction Act penalized drug companies for raising drug prices faster than the rate of inflation starting at the beginning of 2023. An analysis by KFF showed that half of all drugs covered by Medicare had list price increases exceeding the rate of inflation in 2020. For example, Humira, a medication commonly used to treat rheumatoid arthritis, is one of the nation’s highest revenue-generating drugs, raking in $21 billion in sales in 2019. AbbVie, Humira’s manufacturer, has hiked the price of Humira 27 times, including in January 2021 when it raised its cost by 7.4 percent. Over the past 20 years, price increases for brand-name drugs in Medicare Part D have risen at more than twice the rate of inflation. 

Free Shingles Vaccinations. Thanks to the Inflation Reduction Act, 50.5 million seniors are eligible for no-cost shingles vaccinations. In 2020, nearly 4 million Medicare beneficiaries received the two-part shingles vaccination. With a single shot of Shingrix costing $212, seniors on Medicare Part D are saving over $400 on average on vaccinations in 2023. The high out-of-pocket cost of the shingles vaccine has been a key factor in low vaccination rates, especially among Black and Latino communities. This extends an important affordable preventive service to seniors on Medicare; Americans with private insurance could already typically receive shingles vaccinations at no cost.