CMS to Reduce Medicare Part D Costs for 2023

Are Medicare Part D costs getting cheaper?

Earlier this year, Medicare beneficiaries who are currently enrolled in (or interested in enrolling in) Medicare Part D: Prescription Drug Coverage, received some much needed positive news: Medicare Part D costs are in fact trending downward in just one year’s time.

The Centers for Medicare & Medicaid Services (CMS) have recently announced a proposal that would reduce Medicare Part D costs, making prescription drugs more affordable for thousands of Medicare beneficiaries across the nation. CMS’s new proposal will attempt to accomplish this feat by lowering out-of-pocket costs and improving overall price transparency as a whole.

What are these proposed Part D changes?

CMS’s new proposal focuses heavily on the flow of discounts negotiated within Medicare Part D plans themselves. Currently, health insurance providers who offer Medicare Part D plans can cut costs on their via private price concessions, which allow insurance companies to pay less money to pharmacies that fail to meet specific criteria. This is just one example of the many discount tactics that providers may utilize in an attempt to widen profit margins. 

CMS’s new proposal is aimed at increasing price transparency between providers, pharmacies, and those who rely on prescription medications, virtually eliminating hidden backdoor dealings and increasing price awareness for Medicare Part D beneficiaries. CMS’s new rule, in turn, will force insurance companies to pass these savings onto the consumer at the point of sale.

Additionally, under this new rule (which is set to take effect in January of 2023), CMS aims to redefine what the lowest possible payout for medications can be, setting it to be equal to the negotiated price and thereby making it easier for Part D beneficiaries to avoid the Medicare “donut hole”.

2023 will also see the release of real-time benefit-comparison tools by Medicare Part D providers, thanks to a rule passed by the CMS in 2021. The new tool will allow enrollees to compare the prices of different medications and identify their exact co-pay. It can also alert beneficiaries to cheaper generic drugs if one is available. 

In addition to changes in Medicare Part D, the proposal includes several significant reforms, such as new rules for third-party marketing organizations, improved access to care during disasters and emergencies, simplification of the Dual Eligible Special Needs Plan (D-SNP) enrollment process, and changes to the 5-star rating system.

How can I take advantage of the reduced Medicare Part D costs coming in 2023?

If you wish to take advantage of CMS’s new rule proposal as it pertains to your Medicare Part D benefits, you should enroll in a Medicare Part D plan before the end of this year. You can do so as part of your Initial Enrollment Period, or the Annual Enrollment Period, which takes place from October 7th to December 15th.

Great resources, such as MedicareInsurance.com, can connect you with a licensed insurance agent that can help you better understand your options and prepare accordingly. You can contact one of their Medicare Advantage experts today at (800) 950-0608.