Seniors Face Crushing Drug Costs as Congress Stalls on Capping Medicare Out-Of-Pockets

Unlike private health insurance, Medicare Part D drug plans have no cap on patients’ 5% coinsurance costs once they hit $6,550 in drug spending this year (up from $6,350 in 2020), except for very low-income beneficiaries. President-elect Biden favors a cap, and Democrats and Republicans in Congress have proposed annual limits ranging from $2,000 to $3,100. But there’s disagreement about how to pay it. Drug companies and insurers, which support the concept, want someone else to bear the financial burden.

In the meantime, patients rely on financial assistance programs. These arrangements, however, do nothing to reduce prices. In fact, they can even drive up America’s uniquely high drug spending by encouraging doctors and patients to use the priciest medications when cheaper alternatives may be available. Read more here.

(Source: Harris Meyer; Kaiser Health News;1/4/21)