The Inflation Reduction Act Lowers Drug Costs for Medicare members

Medicare will face many changes this year, and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working to make health care more affordable, easier to navigate and accessible for all. That work includes ensuring members have access to affordable prescriptions when they need them.

The Inflation Reduction Act (IRA), which Congress signed into law in 2022 as part of an effort to lower prescription drug costs and expand benefits, continues to drive changes for Medicare plans.

Last year, the IRA implemented a $35 monthly cap on insulin out-of-pocket costs and removed cost-sharing for Part D adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for people with Medicare.

This year, the IRA removed the Medicare beneficiary cost-share in the catastrophic phase and expanded eligibility for the “Extra Help” or Low-Income Subsidy (LIS) Program so more people with Medicare Part D coverage qualify. Some people who already receive help paying for their Medicare costs are automatically enrolled in Extra Help, but that’s not true for everyone.

People with Medicare can see if they’re eligible by visiting Social Security online at SSA.gov/extrahelp or calling Social Security at 800-772-1213. They can also contact their local State Health Insurance Assistance Program (SHIP) at shiphelp.org.

In 2025, the IRA will remove the coverage gap, implement an out-of-pocket maximum of $2,000 for Part D prescription drug costs and launch the Medicare Prescription Payment Plan. People with Medicare may have the option to pay their prescription costs in monthly payments, spread over the year, rather than all at once at the pharmacy. While the Medicare Prescription Payment Plan is available to anyone with Medicare Part D, enrollees with high cost-sharing earlier in the plan year are more likely to benefit from the program.

For more information, visit Blue Cross NC's Inflation Reduction Act webpage.