How Medicare Will Impact Diabetes Patients In 2023

Are you excited to find out what 2023 holds for diabetes supplies and services? Thanks to the Inflation Reduction Act, the cost of insulin and other diabetes-related products and services have decreased significantly. Make sure your healthcare plan is up to date and ready to meet all of your needs in the new year!

Since insulin was first produced, numerous modifications have been patented, but only a select few companies have had access to these cutting-edge developments.

People with diabetes across the country can take advantage of the new Medicare Part D 2023 insurance plan, giving them the opportunity to pay a manageable cost for their insulin.

The devastating effects of diabetes have created an alarming situation, where those in need of insulin to survive are paying outrageous prices. With only a few firms producing the drug, insulin users, their families, and society as a whole, are facing an unbearable burden. This is a critical issue that requires our attention and cannot be ignored.

Starting in 2023, the US government is slashing the monthly cost of insulin for Medicare Part D beneficiaries! Thanks to the inflation reduction act enacted in August 2022, you could pay as little as $35 for insulin every month. Don't miss out on this incredible opportunity! Make sure you pick your 2023 plan through Medicare by December 7, 2022, to take full advantage of the pricing adjustments for insulin. Keep reading to find out more!

90% of the Insulin Market Worldwide is Price Controlled by Just 3 Companies, T1 International Reports

For generations, Eli Lilly, Novo Nordisk, and Sanofi - affectionately known as the 'Big Three' - have monopolized the insulin market with little to no competition. Their ongoing success has been due in part to unorthodox tactics like pay-for-delay agreements - wherein they use patent infringement disputes to stave off potential competitors and offer hefty payouts to keep them out of the market.

Drug manufacturers are exploiting costly legal tactics to block out competition from generic drugs and keep the prices of branded drugs high, according to the Federal Trade Commission (FTC). This strategy - which is being employed by drug manufacturers across the board, not just insulin patents - is costing Americans an extra $3.5 billion every year in prescription drug expenses.

Diabetic Outpatient Renewed Hope on Prescription Drug Benefits with Medicare Part D

Medicare Part D presents a great chance for Medicare recipients to get private prescription drug coverage. Both stand-alone PDPs and Medicare Advantage plans offer the convenience of an outpatient prescription drug plan that private companies provide under government contracts. Take advantage of this opportunity and enjoy the assurance that comes with having access to the medications you need.

As of the beginning of 2022, an estimated 75% of the 65 million Medicare enrollees across the United States, from New York to Arizona, have chosen to enroll in Part D programs. These programs offer a selection of 19 to 28 stand-alone Prescription Drug Plans (PDPs) as well as a variety of Medicare Advantage-Prescription Drug Plans (MA-PDs) available through municipalities.

The Cost of Insulin in 2023 Capped at $35 with the Medicare Part D Plan

Beginning in 2023, Part D members won't pay more than $35 per month for their approved insulin supplies, because of the inflation reduction act. This requirement is based on the current Innovation Center model, which means enhanced Part D insurers must cover insulin products with a $35 monthly co-payment, no matter if it's the deductible, initial coverage, or coverage gap period. A total of 2,881 Part D plans—324 PDPs and 2,559 MA-PDs—will take part in this model in 2023.

Starting in 2023, beneficiaries won't need to be enrolled in a model-participating plan in order to receive the capped $35 monthly payment on insulin co-payments. Unfortunately, not all Part D plans will accommodate all insulin prescriptions at the $35 co-payment limit, as required by the Inflation Reduction Act. Only those insulin products covered by the selected insurance will be eligible for the $35 co-payment.

Impact of Changes to Medicare Part D Under the Inflation Reduction Act

The Inflation Reduction Act will usher in major changes to the Medicare Part D program in 2023, which will be advantageous for those with diabetes. These measures will be implemented gradually to reduce the cost of prescription drugs for both Medicare and those receiving benefits.

Here's a rundown of the changes that have been made!

Are you curious about how much you'll have to pay for insulin and other diabetes-related supplies and services in 2023? Will the Inflation Reduction Act make a difference to your healthcare costs next year? Read on to discover what the future holds for you!

Beginning in 2026, the bill permits the Secretary of the Department of Health and Human Services to negotiate the cost of certain Medicare-covered prescriptions, starting with ten drugs as the first step.

Beginning October 2022 and continuing through September 2023, we will be closely monitoring pharmaceutical price increases under Part D of the Medicare program.

Come 2024, catastrophic coverage will no longer have any coinsurance requirement, and your out-of-pocket expenses will be capped at a maximum of $2,000 by 2025.

Starting in 2025, Part D plans and drug manufacturers will need to provide more financial support for catastrophic coverage costs.

Beginning in 2023, Part D plans will offer free coverage for adult vaccinations and will only charge a maximum of $35 a month for insulin supplies.

By 2024, those who qualify will receive full payments through the Medicare Part D Low-Income Subsidy program, providing increased economic security for those in need.