The Inflation Reduction Act (IRA) became law on Aug. 16, 2022, and includes several provisions to lower prescription drug costs for patients with Medicare and reduce drug spending by the federal government.
Changes to Part D program
Effective Jan. 1, 2023, all Medicare Part D plans are required to have a $35 cost-share cap for Part D-covered insulin products.
Effective Jan. 1, 2023, all Medicare Part D plans are required to offer vaccines recommended by the Advisory Committee on Immunization Practices at a $0 cost share with no deductible.
Better Rx benefits for Humana’s Medicare plans
Changes to Medicare Part B benefits
Beginning April 1, 2023, Humana-covered patients may pay less for certain drugs covered by Medicare Part B benefits based on a new and lower “coinsurance” amount (their share of the prescription cost after they meet their deductible). The list of eligible drugs will be updated every 3 months. Any reduction in patients’ out-of-pocket cost for eligible drugs will be made when they pay for their prescriptions at the pharmacy. For patients who receive Medicare Part B drugs at a location other than a pharmacy, Humana will ensure patient cost share is adjusted where appropriate. For patients who receive these Part B drugs at these locations, Humana will mail a refund where appropriate until systems are fully updated to allow for adjustment as part of normal claim processing.
Please note these changes do not apply to Medicare Part D prescription drug coverage.
This list will be updated every 3 months.
More potential savings
Starting July 1, 2023, if Humana-covered patients take insulin that is covered by their Medicare Part B benefits, their plan deductible will no longer apply to their Medicare Part B insulin prescription. Patients will pay no more than $35 for a 1-month (30-day) supply of a Part B-covered insulin. This cost limit applies to insulin dispensed through a pump or Medicare-covered durable medical equipment.
Claims processing
Humana claims processing logic for both of these provisions will be implemented prior to Jan. 1, 2023, and no additional action will be required by prescribers or pharmacies for patients to obtain these benefits.