The recently passed Inflation Reduction Act (IRA) makes some key changes to Prescription Drug Plans (PDP) with the goal of keeping member costs low. Over the next several years, these changes will be phased in, beginning to impact members in 2023. Some changes that will impact members are:
- Insulin | Starting in 2023, all plans will have a cap member cost sharing for insulins at $35 for a one-month supply. However, Mutual of Omaha Rx℠ Premier plan will still offer the $25 one-month copay for select insulins.
- Vaccines | Members will no longer have any cost sharing for vaccines, including the shingles vaccine. In addition, some vaccines may be completely covered by Medicare.
- Member out-of-pocket spending | The current out-of-pocket amount for the catastrophic phase will be removed over the next few years. In 2024 the benefit phases will still be in place, but the member cost share in the catastrophic phase will be eliminated, meaning members will not have to pay out-of-pocket to fill drugs if they are in the catastrophic phase. In 2025, there will be a bigger Part D redesign with changes to the phases and maximum out-of-pocket amounts.
- Drug negotiation | Beginning in 2026, the Federal government will begin negotiating drug prices with manufacturers. The list of drugs to be negotiated grows each year and will eventually include Parts B and D drugs.
If you have further questions, please reach out to Sales Support at (800)-693-6083.
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