By Patricia Prewitt
My Personal Rx Adviser

Phew! You selected your new Medicare Part D or Medicare Advantage plan during open enrollment at the end of 2023. Now it’s time to see how it really works. The Inflation Reduction Act of 2022 included many provisions to help lower drug costs with Medicare and to reduce spending by the federal government. Here are a few things to know about this complex legislation:
What can I expect in 2024?
First, the annual prescription deductible may not exceed $545. Plans vary widely. Your plan may not have a deductible at all. The prescription costs at the beginning of the year may seem really high until that annual deductible is paid.
What happens after I have paid my Med D Prescription Plan deductible?
Your portion of the costs at the pharmacy will depend on the medication(s), and which “tier” that drug is assigned on the plans formulary. There are five tiers of medications. Tier 1 is the least expensive. In fact, some Tier 1 medications may be included with your plan at no cost. Others, such as Tier 3 (the lowest cost tier for brands) preferred branded medications will likely range between $35 and $60 for a monthly copay/coinsurance amount. A 90-day prescription may save money, but not always.
Once you and your plan provider have paid $5,030 (including the deductible) you will pay no more than 25% of the cost for medications until the total out-of-pocket is $8,000 – the “catastrophic” threshold for 2024.
That seems complicated. What happens if I need to take expensive, brand-name drugs?
According to an analysis by www.kkf.org (April 20 2023), an independent source for health policy, Medicare Part D enrollees who take only brand-name medications will have spent about $3,300 out of their own pockets before having little to no additional costs for their medications in 2024. This is a reduction of $1,360 compared to 2023, which estimated enrollee out-of-pocket annual costs at $4,660.
Are there any realistic options for reducing my medication costs if I am on Medicare?
People are often surprised to learn they may qualify for patient assistance from brand-name manufacturers. Each program has unique rules, but some allow incomes of between 300-500% of the federal poverty level income. Another option is to check Medicare.gov for extra help, although income and asset limits are quite low.
What else changed for 2024?
Plans may not increase their premiums by more than 6% annually from the base beneficiary premium. I was happy to read this, as I had an unexpected mid-year increase of 12% to my Medicare Part D drug in my first year as a Medicare enrollee.
The Inflation Reduction Act of 2022 has many elements that will affect Medicare enrollees that are being phased in over time. A big piece of this legislation is the ability of the government to negotiate prices for often-prescribed brands. The list for the first 10 branded medications starting in 2026 can be found here: https://www.hhs.gov/about/news/2023/08/29/hhs-selects-the-first-drugs-for-medicare-drug-price-negotiation.html
Starting in 2027, the number of drugs will climb to 15 per year, based on utilization and cost factors.
Anything else?
Make sure that your 2024 prescription plan is correctly registered with the pharmacy. Computer systems do not always work seamlessly to transfer data, especially if you are new to Medicare and have moved from a previous employer plan or changed plans. Check to be sure your price at the counter is about what you expected to pay.

About the Author: Patricia Prewitt is a local Massachusetts resident who spent over 30 years in
the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: “Act as if what you do makes a difference. It does.” – William James

Content provided is for education purposes only, and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.