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The Inflation Reduction Act and Medicare: What to

时间:2025-07-17 14:45来源: 作者:admin 点击: 3 次
Over the coming years, the Inflation Reduction Act aims to save people with Medicare money on their prescription medications. Read more.

The Inflation Reduction Act (IRA) was implemented to manage the ever-increasing costs of prescription medications, specifically under Medicare. It also allows drug price negotiations and manufacturer rebates.

In 2022, President Joe Biden signed the Inflation Reduction Act (IRA), which aims to minimize the effects of rising U.S. healthcare costs.

The 2022 IRA makes vaccinations free for everyone with Medicare and caps out-of-pocket costs for millions more.

The act also authorizes Medicare to negotiate some drug prices directly with drug manufacturers — the first time this has been allowed.

How does the Inflation Reduction Act affect Medicare?

Since President Biden signed the act, many changes have been implemented, and more are due to take place in the future.

Manufacturer rebates to Medicare

From 2023, drug manufacturers began paying Medicare rebates for medications included in Part D plans if the price increases for those drugs exceeded the rate of inflation. This has meant a much slower overall price increase.

Some medications are eligible for payment under Part B. And from 2028, the IRA will begin adding Part B drugs to the negotiation program.

Insulin price caps

Under the Medicare prescription drug benefit, insulin costs were capped at $35 from October 1, 2022, until January 1, 2024. Then, insulin was either capped at $35 or 25% of a plan’s negotiated price, whichever was less. This applies even if you haven’t met your Part D prescription drug plan deductible.

Extra Help availability increases

In 2024, Medicare’s Extra Help program changed, resulting in more people being eligible and experiencing greater savings on their prescription medications.

If you qualify for Extra Help, you’ll pay a $0 premium and deductible for your Part D prescription drug plan, as well as the following out-of-pocket costs:

Drug price negotiations

From 2026, Medicare-negotiated drug prices will start to take effect.

For the first time in history, Medicare has the legal power to directly negotiate prices of specific high cost medications.

Different medications have been selected for negotiation over the coming years:

10 drugs for 2026 negotiationCommonly prescribed for
Eliquis   • preventing and treating blood clots  
Enbrel   • rheumatoid and psoriatic arthritis
• psoriasis
 
Entresto   • heart failure  
Farxiga   • diabetes
• heart failure
• chronic kidney disease
 
Fiasp
Fiasp FlexTouch
Fiasp PenFill
NovoLog
NovoLog FlexPen
NovoLog PenFill
  • diabetes  
Imbruvica   • blood cancer  
Januvia   • diabetes  
Jardiance   • diabetes
• heart failure
 
Stelara   • psoriasis
• psoriatic arthritis
• Crohn’s disease
• ulcerative colitis
 
Xarelto   • preventing and treating blood clots
• reducing risk for people with coronary or peripheral artery disease
 

15 drugs for 2027 negotiationCommonly prescribed for
Austedo
Austedo XR
  • chorea in Huntington’s disease
• tardive dyskinesia
 
Breo Ellipta   • asthma
• chronic obstructive pulmonary disease (COPD)
 
Calquence   • chronic lymphocytic leukemia
• small lymphocytic lymphoma
• mantle cell lymphoma
 
Janumet
Janumet XR
  • type 2 diabetes  
Ibrance   • breast cancer  
Linzess   • chronic idiopathic constipation
• irritable bowel syndrome with constipation
 
Ofev   • idiopathic pulmonary fibrosis  
Otezla   • oral ulcers in Behcet disease
• plaque psoriasis
• psoriatic arthritis
 
Ozempic
Rybelsus
Wegovy
  • type 2 diabetes
• type 2 diabetes and cardiovascular disease
• obesity and cardiovascular disease
 
Pomalyst   • Kaposi sarcoma
• multiple myeloma
 
Tradjenta   • type 2 diabetes  
Trelegy Ellipta   • asthma
• COPD
 
Vraylar   • bipolar I disorder
• major depressive disorder
• schizophrenia
 
Xifaxan   • hepatic encephalopathy
• irritable bowel syndrome with diarrhea
 
Xtandi   • prostate cancer  

Takeaway

The IRA aims to save people money on their prescription medications in many ways, and these cost savings should continue over the coming years.

A greater number of older adults with fixed incomes and limited resources can benefit from Extra Help. And the drug negotiations taking place until 2029 could mean greater medication savings for everyone with Medicare.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

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