Medicare enrollees face higher drug costs despite $2,000 cap

Medicare patients may have noticed a cost increase in prescription drugs due as drug insurers respond to a cap placed on out-of-pocket costs.

“It’s a complicated story,” said Rich Daly, a senior editor with the Healthcare Financial Management Association. The Inflation Reduction Act of 2022 implemented a range of changes to Medicare that affected medications, including a $2,000 cap on out-of-pocket costs for enrollees with prescription drug plans.

“Drug insurers have responded to the new rules by implementing out-of-pocket costs short of that costs,” he said. “The overall effect is, a small number – about 5% of enrollees – will be protected by that $2,000 cap, but a much larger number of enrollees have much larger out-of-pocket costs than they used to have.”

Daly said there are two main