While proposed changes to Medicare and Medicaid could significantly lower consumers’ out-of-pocket prescription expenses, the savings may not be seen by most people for some time.

Key takeaways:

• Many patients with chronic illnesses are forced to skip doses, cut back on other necessary expenses, or skip prescriptions altogether due to high costs.
• Prescription drug costs are set to decrease for Medicare and Medicaid beneficiaries.
• The U.S. Department of Health and Human Services has proposed a fixed co-payment of $2 for around 150 generic drugs.
• The Centers for Medicare and Medicaid Services (CMS) will test the models in the Medicare and Medicaid programs.
• The plan could save beneficiaries billions of dollars annually in out-of-pocket costs.
• There is currently no start date for the first model.

While proposed changes to Medicare and Medicaid could significantly lower consumers’ out-of-pocket prescription expenses, the savings may not be seen by most people for some time.

Prescription medication is a crucial part of everyday life for many individuals struggling with a chronic illness. But the high cost of these necessities has been a major concern for citizens in the United States. 

Lowering prescription drug costs is a vital area of health policy that generates immense public interest and concern. And for good reason – it affects a majority of American citizens. Six in ten adults currently take at least one prescription on a regular basis, and a full 25 percent of those surveyed take a whopping four or more.

Thankfully, the U.S. Department of Health and Human Services (HHS) has proposed a new plan to decrease prescription drug costs for Medicare and Medicaid beneficiaries. In this blog, we’ll explore why the price of medication is on the rise, the impact of the Inflation Reduction Act, what’s in store for this year, and how you can start saving on your prescription medications immediately. 

The cost of missing doses 

According to recent research, 37 percent of respondents have skipped filling a prescription due to the excessive cost. But skipping out on vital medication can seriously damage your health and lead to even more significant costs in the future. 

Chronic illnesses require careful and constant management as well as strict adherence to treatment plans. Skipping medications – or even just a few doses – can cause symptoms to worsen, resulting in more severe health conditions that require more intensive (and expensive) medical interventions, including emergency-room visits, hospitalizations, and specialized treatments. Unfortunately, too many patients are put in this position because of the soaring prices of prescription medications.

And out-of-control drug prices don’t just affect individuals who struggle to pay for the care they need. The cascading effect of more hospitalizations, more ER visits, and more expensive treatments impacts the entire healthcare system – with healthcare consumers bearing the brunt of the cost.

So what is the solution? 

The first step is recognizing that the United States has a prescription drug price problem, with the poor and the elderly bearing the brunt. Next, it’s time to reshape public health policy and ensure greater affordability of medications to improve health outcomes and quality of life for all. 

The U.S. Department of Health and Human Services is already taking action to make that happen. It plans to decrease prescription drug costs for Medicare and Medicaid beneficiaries, thanks to the Inflation Reduction Act. 

Prescription drugs and the Inflation Reduction Act 

United States drug pricing is outpacing inflation. But within the recently passed Inflation Reduction Act, there are two policies designed to make drug prices more affordable for those who rely on government programs for their healthcare needs. 

The Centers for Medicare and Medicaid (CMS) will test two models for reducing prescription costs in the Medicare and Medicaid programs. Trials will begin with people over age 65, disabled patients, and the Medicaid program for the poor. 

The first model, one of the most prominent measures, will be the implementation of a fixed co-payment for around 150 generic drugs. This will ensure that beneficiaries can access their prescribed medications without having to deal with exorbitant pricing. It could potentially save beneficiaries billions of dollars in out-of-pocket prescription drug costs each year. By setting a low-yet-consistent co-payment system, individuals will be able to plan their healthcare budgets and avoid any uncertainty when it comes to paying for their medications. 

The second model allows state Medicaid agencies to cover cell and gene therapies through a delegation of authority to CMS. This will help CMS streamline the procedure by facilitating contacts and payment models. 

Together, these new policies form part of a larger strategy to make healthcare more affordable for all Americans. 

What’s in store for the rest of 2023 

Although there is currently no start date for trials of the first model to begin, many exciting developments are expected to come later in 2023. Let’s take a look at some notable measures of the prescription drug provisions in the Inflation Reduction Act. Later this year, Medicare and Medicaid beneficiaries can hope to see: 

• Reduced costs and improved coverage for adult vaccines 
• Insulin co-pays capped at $35 per month 

Additionally, pharmaceutical manufacturers will be forced to pay rebates to Medicare for increasing drug prices faster than the pace of inflation, providing a significant incentive for keeping costs down. 

How to save on your prescriptions right now

Without a doubt, the price of prescription medication is difficult to keep up with, especially for those taking four or more. Which is why many people can’t afford to wait until these new government programs take effect. If you need relief from the high cost of your prescriptions right away, ModRN Health is here to help. 

ModRN Health makes saving money on prescription medication as easy and effortless as possible. All you need to do is sign up for a free account, use our comparison tool to find the best prices in your area, and start saving up to 90% on prescription drugs. 

But that’s not the only benefit. As an ModRN Health customer, you can also accumulate reward points that are fully redeemable for gift cards to your favorite store. You can earn points by signing up and refilling your prescriptions, and even for inviting a friend to join the ModRN Health community. 

If that sounds good, go create a free ModRN Health account and start saving money on your medications today.