“Ask NAPCA” advisory: Recent changes made to Medicare’s Part D

by PDM NEWS STAFF

NEW YORK — The Philippine Daily Mirror, in cooperation with the National Asian Pacific Center on Aging (NAPCA), has adopted “Ask NAPCA” as a monthly feature to inform Asian Americans and Pacific Islanders (AAPI) elder communities of available programs and services they may need wherever they live in the US.

This month, NAPCA has selected some questions about recent significant changes Congress made to Medicare’s Part D benefit through the Inflation Reduction Act (IRA).

<Q1> What Are the Changes to Medicare Part D?

The new rules are designed to make it easier for seniors to afford prescription drugs. For the first time, the federal government negotiates prices on certain medications covered through Medicare. The law establishes annual limits on out-of-pocket spending for all drugs, with a special cap for insulin. Beneficiaries can also spread their cost-sharing throughout the plan year, and you no longer have to pay out of pocket for adult vaccines recommended by the Centers for Disease Control.

<Q2> How will my drug costs be affected?

First, your monthly spending is now capped at $35 if you use insulin. It is excellent news for many seniors with diabetes, especially those in the Asian American and Pacific Islander communities, who are more likely to have diabetes.

Second, starting in 2025, there will be a $2,000 annual limit on how much you pay for all prescription drugs covered through Medicare. No matter how many medications you need, your yearly cost won’t exceed $2,000. Note that the annual limit is $8,000 in 2024.

Third, starting next year, you can spread your drug costs evenly over the year instead of paying large amounts simultaneously. This option could make it easier to manage your budget if you’re on a fixed income. But remember, you need to opt-in for this option — it won’t happen automatically. If you have questions, we encourage you to contact your Medicare drug plan insurer directly.

<Q3> Can I receive more assistance with my Medicare prescription drug costs?

Medicare beneficiaries may qualify for even more savings through the Low-Income Subsidy (LIS) program, also called the Extra Help program. In 2024, Extra Help is expanded so that beneficiaries who earn between 135% and 150% of the federal poverty level and meet the resource limit requirements can receive full Extra Help benefits. In other words, if your monthly income is up to $1,903 (or up to $2,575.00 for a couple), you will pay $0 for your Medicare drug plan premium and plan deductible and a reduced amount for generic and brand-name drugs. These limits are updated annually.

<Q4> I have heard that the new legislation may impact some of my medications — is that true?

Some experts are worried that the price-setting rules of the IRA could have unintended consequences — like slowing down the development of new drugs, especially pills that are easy to take at home, and making it harder for seniors to access medicines they currently take.

A balanced approach to implementing the law could help mitigate these access and affordability challenges. For instance, Medicare officials could monitor insurers to ensure they don’t put certain brand-name drugs into higher-cost categories, which forces seniors to pay more out-of-pocket.

Giving pills the same level of protection that injectable drugs receive would encourage drug companies to continue developing both types of medicines. It would also help ensure seniors can access the best treatments for their personal health needs.

Suppose you have additional questions about Medicare, Medicaid, Affordable Care Act Health Insurance Marketplace, Social Security Retirement Benefit, Supplemental Security Income, Medicare Savings program, food/home energy assistance, or COVID/Flu vaccination. In that case, there are three ways you can reach us today:

Call NAPCA’s Senior Assistance Center at (English) 1-800-336-2722, (Chinese Cantonese) 1-800-582-4218, (Chinese Mandarin) 1-800-683-7427, (Korean) 1-800-582-4259, (Vietnamese) 1-800-582-4336

Email: askNAPCA@napca.org,

Mail: 1511 3rd Avenue, Suite 914, Seattle, WA 98101

National Asian Pacific Center on Aging (NAPCA) is a non-profit organization dedicated to improving the quality of life of AANHPI older adults and their families. We operate an NAPCA Senior Assistance Center for Older Adults and Caregivers, available in five different languages: English, Chinese Cantonese, Chinese Mandarin, Korean, and Vietnamese.

–With Jay Domingo/PDM

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