In the third quarter of 2023 – specifically, from July 1 to Sept. 30 – there are 43 drugs covered under Medicare Part B that will have their coinsurance rates changed based on an inflation-adjusted payment amount. This adjustment is relevant to those individuals enrolled in both traditional Medicare and Medicare Advantage, and those who will use these specific drugs.
Depending on additional health coverage held by such individuals, this adjustment may result in a reduction in the coinsurance payments for which they are responsible. The savings that beneficiaries can expect to experience are tangible, with the coinsurance amounts potentially being lower than they would have been prior to the enactment of the new law.
The range of these savings is likewise quite substantial, varying from as little as $1 to as much as $449 per average dose. This range demonstrates the potential significant financial impact the new law could have on beneficiaries’ out-of-pocket healthcare costs.
This is great until you look at the 43 drugs selected. They do not appear to be the drugs that drain the pocketbooks of the elderly. I was surprised to see the drug Humira, used to treat psoriasis, on the list, considering how heavily it has been marketed.
I was also disappointed to see Vivitrol make the list. More commonly called “Naltrexone,” Vivitrol is an opioid antagonist, meaning it blocks the pleasurable effects of drinking.
The controversy with Naltrexone and drugs like it is that they are directly contrary to the last 90 years of information from recovery programs indicating that the only solution to addiction is complete abstinence.
There are so many drugs that Medicare recipients need and can’t afford. Let’s hope Medicare picks more wisely next time.