Wisconsin's Weekend Morning News
New Changes to Prescription Costs
Millions of Americans are facing a little bit different rules out of their out-of-pocket prescription drug cap through Medicare Part D. And joining us is Lee Purvis. She is the prescription drug policy principal for AARP and Lee. Can you break it down for us? What are some of these changes we're going to say? Sure. We are going to see a very important change starting in 2025, which is that out-of-pocket expenses are going to be capped for people in Medicare prescription drug plans, which is really important because previously there was no limit on how much people had to spend on their prescription drugs. And we know that there were some people spending upwards of $10,000 per year just on prescription drugs. Wow. So what would be the number now? If you're spending $10,000 out-of-pocket before the end of the year, what is it going to be for 2025? In 2025, the cap is going to be $2,000, which is obviously a huge saving for the people who are spending so much money. Sure. And how many Americans do you think will be covered by this? I mean, will it make a significant difference for people? It absolutely will. AARP actually just undertook some research to look at how many people are going to benefit from this new cap. And we found that next year, about 3 million people are going to hit the cap. And by 2029, more than 4 million people are going to hit the cap. So the number of people who are going to benefit will be growing over time. With an aging population, I can see that it will affect people over time. Will we see this number change again? Or do you think this is going to be the cap for the foreseeable future? So the cap is going to move with the other parts of the Medicare Part D benefit, which is what the Medicare prescription drug plans follow. So there's like a deductible and things like that. And those change with spending under that program. So we will see some changes that $2,000 cap, but the expectation is it's not going to change very much, at least for the next several years. How important do you think this change of legislation is to the average American? Oh, it's incredibly important. For people who were facing those high-out-of-pocket costs, a lot of them were having to choose between paying for their prescriptions and paying for other things like their food or their rent. And this is going to go a long way towards making it where they don't have to make those types of decisions. Now, I know that there's a number of people who get Medicare. Not all of them are covered by Plan D. What differential is there? So Medicare Part D covers about 56 million people in Medicare, and there's about 66 million people overall in the Medicare program. So it covers a pretty good share of people who do have Medicare. And so these changes are specific to people who are in those Medicare prescription drug plans. At AARP, have you done any studies indicating what the best choices are for seniors who are covered by Medicare? That is a great question, and it's actually very individualized. It really depends on what prescription drugs you're taking, and you want to make sure that your plan covers the drugs that you're taking, and then also covers them in a way that you can afford. So it's actually something that we highly recommend everyone look into every year during Medicare Open Enrollment, which is from October 15 to December 7 every year, and really take a look at your plan options and make sure you're in the best one for you. And what does AARP offer in terms of information? Is there a place where we can go to find out more? People who want to learn more about these issues can go to AARP.org/part D spending cap. Lee Purvis from AARP, you're the prescription drug policy principal. Thanks so much for sharing this information with us. Thank you for having me.