In case you missed it, important new legislation was passed by the Senate that included some major healthcare provisions. The bill goes on to the House which is expected to act on it later this week.
MEDICARE
The biggest improvement for Medicare members would be the establishment of an annual cap on prescription drug out of pocket expenses of $2,000. Currently, there is no cap. We have clients that need high-priced drugs who are experiencing considerably higher out-of-pocket expenses. This provision does not kick in until 2025.
A second provision addresses the cost of insulin with limits of $35 per month on copays. Many Medicare plans already limit copays to $35 during the initial and “donut hole” stages of coverage, but do not include the “catastrophic” stage. We are awaiting clarification as to whether the catastrophic stage will be included in the new legislation. If so, it would provide relief for many diabetics.
Finally, there are provisions for Medicare to negotiate directly with pharmaceutical companies on the cost of some (but not all) drugs.
INDIVIDUAL/FAMILY ACA PLANS
This bill also extends the expanded tax credits that started mid-2021 with the passage of the American Rescue Plan. That bill increased tax credits dramatically and also increased income limits at which you are eligible for tax credits to lower your premium. Now, you can keep those greater tax credits through at least 2025.
We will continue to keep you updated with any additional legislation that affects the Medicare and the ACA Marketplace plans.