Medicare Announces Price Negotiations on 10 Prescriptions
Medicare just announced the 10 medications they will begin negotiating the prices with the manufacturers. Prescription pricing negotiations were part of the Inflation Reduction Act passed in 2022 and will be phased in. Starting in 2026 10 medication’s prices will be negotiated. Medicare will then add 15 more medications for 2027 and continue adding more medication each subsequent year.
Manufacturers of the prescriptions have filed lawsuits claiming that prescription pricing negotiations are unconstitutional, however Medicare negotiates the pricing for all other medical services and it is unlikely that claim will hold up in court.
Here’s a list of the first 10 medications.
- Eliquis, a blood thinner
- Xarelto, a blood thinner
- Januvia, a diabetes drug
- Jardiance, a diabetes drug
- Enbrel, a rheumatoid arthritis drug
- Imbruvica, a drug for blood cancers
- Farxiga, a drug for diabetes, heart failure and chronic kidney disease
- Entresto, a heart failure drug
- Stelara, a drug for psoriasis and Crohn's disease
- Fiasp and NovoLog, for diabetes
These are all common medications and once the negotiations begin the pricing at the pharmacy will save consumers a significant amount, especially during the Coverage Gap or “Donut Hole” stage.Medicare prescription drug costs change throughout the year. Some plans include a deductible, which has to be reached prior to paying for medications. After the deductible is met, the pricing at the pharmacy is based on which Tier the medication falls in and the corresponding cost share. If the total cost of what the consumer has paid, plus the drug plan has paid combined adds up to $4,660 then the Coverage Gap phase begins, and you will pay 25% of the cost of the medication.
For example- Eliquis full price is approximately $625 per month so if you hit the coverage gap, the 25% would be $156 for one month's supply. The negotiating of pricing will reduce these costs.
Medicare Annual Election Period begins in October!
We will be reaching out in the next week to request an updated list of your medications. Look for a letter and email from us so that we can be prepared to assist you with your 2024 coverage options.
- Medicare Announces Pricing Negotiation on 10 Prescriptions
- New and Expanded state assistance programs for Seniors in New Jersey - NJ PAAD, Senior Gold, NJ Freeze & Stay NJ
- Supporting a loved one on Medicare in New Jersey
- Five reasons to work with a Medicare Insurance Broker in New Jersey
- NJ FamilyCare, PAAD, and Senior Gold Renewal- Post COVID-19 Emergency Declaration
- 6 Ways to Prepare for Medicare if You’re Working Past 65
- Medicare updates for 2023!
- Medicare Annual Election Period ends 12/7 and NJ State Assistance thresholds have updated for 2023!
- Medicare Advantage Versus Medicare Supplement – What’s the difference?
- Shingles vaccines are $0 in 2023 thanks to the Inflation Reduction Act!
- Medicare Premium is Going Down in 2023! Medicare Annual Enrollment Period is here!
- Protecting Yourself Against Medicare Scams
- Medicare changes when moving to or from New Jersey
- Medicare Premium Payment Options
- NJ PAAD and Senior Gold raised their qualifications by $10,000 in 2022!
- The Medicare Advertisements should stop after December 7th!
- Medicare Open Enrollment Period Continues Until December 7th
- 2022 Medicare Open Enrollment Period
- What will you be billed for a hospital stay with Medicare coverage?
- Understanding Medicare and IRMAA - Income Related Monthly Adjustment Amount
- Does Medicare Cover Gym Membership?
- Are you insured when traveling with Medicare?
- Medicare and Dental
- What to Know when you Qualify for Medicare due to Disability in New Jersey
- What to Know About Medicare and COBRA
- What to Know About Visiting a New Jersey Social Security / Medicare Office
- Options for New Jersey Prescription Help
- How Important is the Medicare Star Rating?
- Medicare Assignment
- Why Should You Engage with a Medicare Broker?
- President Biden’s Medicare Plan
- A Guide to Medicare HMO and PPO Options
- Medicare Part D Senior Savings Model: An Overview
- Do You Need Help with Medicare.gov?
- Medicare and Acupuncture
- Medicare vs Medicaid: What's the Difference?
- What to Do When Helping Parents with Medicare
- Understanding the Medicare Plans in NJ
- Medicare and Coronavirus
- Delaying Medicare Part B
- Finding Medicare Assistance
- How Do I Sign Up for Medicare Part B in New Jersey?
- Medicare Help—Making Medicare Easy
- PAAD: New Jersey's Prescription Assistance Program
- Medicare Insurance Agents and Brokers
- Finding Your NJ Medicare Broker
- Medicare Part D Eligibility
- Medicare Advantage (Part C)
- New Jersey's Dual-Eligible Special Needs Plans - The Facts
- Medicare Eligibilty Age
- Medicare through Social Security Disability in New Jersey - You Don't Just Age into the System
- New Jersey Senior Gold Assistance Program- What You Need to Know
- Assistance Programs in New Jersey for Medicare Eligibles
- Top 7 Medicare Mistakes
- Utilizing Your New Jersey Medicare Insurance Agent
- Medicare and High Income: Does Income Change the Cost of Medicare?
- Changing Medigap Plans
- Why Am I Getting A Bill For a Medicare Physical Exam
- How Medicare Brokers Can Help
- Republican Plans for Medicare in 2020
- What You Need to Know About Medicare in New Jersey
- NJ PAAD Application Help
- What Really Is Medicare for All?