Administration continues to keep out-of-pocket drug costs low for older adults

CMS announced Wednesday the average basic premium for Medicare Part D prescription drug plans will be $30.50 in 2021. The agency noted that Part D premiums have dropped by 12% since 2017, allowing beneficiaries to save nearly $1.9 billion in premium costs during that time. Additionally, enrollment in the Part D program has increased by 16.7% since 2017. CMS Administrator Seema Verma noted that “Part D premiums continue to stay at their lowest levels in years even as beneficiaries enjoy a more robust set of options from which to choose a plan that meets their needs.” CMS also highlighted the administration’s efforts to curb costs for beneficiaries, including the launch earlier this year of the Part D Senior Savings Model. The model will allow Medicare beneficiaries to select a plan that provides access to a broad set of insulins at a maximum $35 copay for a month’s supply. Beginning in 2021, beneficiaries who choose these plans will save, on average, $446 per year, or 66%, on their out-of-pocket costs for insulin, CMS said. Beneficiaries will be able to select from more than 1,600 participating standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage, all across the country during the upcoming open enrollment period, which runs from October 15 through December 7. CMS noted that improvements to the Medicare Part D program that it has made thus far include: beginning in 2021, providing more information on out-of-pocket costs for prescription drugs to beneficiaries by requiring Part D plans to provide a real time benefit tool to clinicians with information that they can discuss with patients on out-of-pocket drug costs at the time a prescription is written; implementing Part D legislation signed by President Trump to prohibit pharmacists “gag clauses”; providing beneficiaries with more drug choices and empowering beneficiaries to select a plan that meets their needs by allowing plans to cover different prescription drugs for different indications; and reducing the maximum amount that low-income beneficiaries pay for biosimilars.