Big changes are underway for Medicare participants, after historic legislation put them in motion this month.
More than 1.8 million Georgians who are Medicare enrollees will see lower-cost premiums and deductibles, and can save money on some prescription drugs.
Leigh Purvis, senior director of health care costs and access at the AARP Public Policy Institute, described a few of the changes.
“The first is that recommended vaccines will now be free for Medicare beneficiaries,” Purvis pointed out. “The second is that insulin costs will now be limited to $35 per month for people who are in Medicare prescription drug plans. And the third is that drug companies are now going to be penalized for increasing their prices faster than the rate of inflation.”
She explained Medicare “Part B” premiums are deducted from people’s monthly Social Security payments. Since this year’s Social Security’s cost-of-living adjustment increased benefits by 8.7%, she noted people who are already enrolled in both programs will see more money in their pockets each month.
Purvis added more than 100,000 people in Georgia use insulin to manage their diabetes, and lowering the cost will help those who have struggled to afford insulin.
“As long as that insulin is covered by their prescription drug plan,” Purvis explained. “That’s really important because we know that previously, some people were facing, on average, monthly costs of around $50. And some people were paying more than $100. “
Purvis added this year, Medicare will start phasing in annual limits on how much people have to spend out of pocket on their prescriptions. As of 2025, the new limit will be $2,000 a year.
“And that is real savings, because we know that there are people out there who have been spending upwards of $10,000 per year on their prescription drugs,” Purvis observed. “Now, people in Medicare prescription drug plans will have a relatively low and meaningful out-of-pocket limit on their prescription drug costs every year.”
Medicare price negotiations will start with 10 drugs. People will learn what they are by this fall, and the negotiated prices will take effect in 2026. Medicare will add more drugs every year, and patients could see as many as 60 prescription drugs with negotiated prices by 2030.
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