Spanberger Working to Inform Seniors of Historic Improvements to Medicare Ahead of Open Enrollment Period

Open Enrollment for 2023 Medicare Plans Begins Saturday, October 15 and Lasts Until December 7

HENRICO, V.A. — Ahead of the Medicare open enrollment period, U.S. Representative Abigail Spanberger today encouraged the Centers for Medicare and Medicaid Services (CMS) and the Administration for Community Living (ACL) to spread awareness about the improvements to Medicare in the Inflation Reduction Act.

Beginning on Saturday, October 15, Virginia seniors can compare their personalized coverage options for 2023 and take advantage of decreased costs right away. The Inflation Reduction Act — which Spanberger voted to pass in August — caps out-of-pocket insulin costs at $35 per month for Medicare beneficiaries and eliminates cost-sharing for recommended vaccines effective January 1, 2023. The law also gives Medicare the power to negotiate prescription drug prices, limits out-of-pocket drug costs to $2,000 per year beginning in 2025, and prevents pharmaceutical companies from raising the price of their products faster than inflation. Last month, CMS announced that Medicare beneficiaries will see lower average premiums for Medicare Part B, Medicare Advantage, and Medicare Part D prescription drug plans in 2023.

Virginia seniors can use the Virginia Insurance Counseling and Assistance Program (VICAP) to receive free, unbiased counseling and compare the quality of care and services offered to maximize their Medicare benefits for 2023. With capped out-of-pocket insulin costs and many vaccines available at no cost, many seniors enrolled in Medicare plans with higher premiums may be able to choose alternative plans with no change to their insulin or vaccine benefit.

In a letter to CMS and ACL, Spanberger called on the agencies to use their resources to inform America’s seniors about the upcoming Medicare open enrollment window. Additionally, the Congresswoman underscored how specific provisions in the Inflation Reduction Act will deliver results to lower costs for seniors in Virginia and across the country.

“These provisions will improve seniors’ access to health care, strengthen the Medicare benefit, and save seniors money over the long term,” said Spanberger. “In 2020, the average senior spent $54 out-of-pocket on each insulin prescription – more than 50% higher than the new $35 monthly out-of-pocket cap. For many seniors the cost of the two-dose shingles vaccine could be as high as $162 per shot – the new law makes it available to Part D enrollees without co-pay in 2023. Nearly 85,000 Virginian seniors received a vaccine through Medicare Part D in 2020 and could see their cost-sharing reduced by this provision.”

Spanberger continued, “I reiterate the importance of Medicare beneficiaries being aware of these improved benefits so they can make an informed choice about the plan that is best for them during this year’s open enrollment and take full advantage of the Inflation Reduction Act’s historic cost savings.”

Click here to read the letter, and the full letter text is below.

Dear Administrator Brooks-LaSure and Acting Administrator Barkoff,

I write to encourage the Centers for Medicare and Medicaid Services (CMS) and the Administration for Community Living (ACL) to do everything possible to ensure America’s seniors are informed about the Inflation Reduction Act’s improvements to Medicare during open enrollment. This law contains life-changing provisions– limiting insulin co-pays to $35 per month and eliminating cost-sharing for many vaccines – that will provide much needed relief and peace of mind to millions of seniors. These changes go into effect in 2023, and seniors need to be aware of these changes as they are selecting their plans for next year to take full advantage of the new benefits.

In August, I was proud to vote for the historic Inflation Reduction Act to finally give Medicare the power to negotiate prescription drugs and address the long-standing concern that American seniors pay ten times – or more – what other countries pay for the same drugs. Many important provisions of the Inflation Reduction Act – such as eliminating co-insurance in the catastrophic phase of the Medicare Part D benefit, implementing negotiated prices of high-cost drugs, and creating a $2,000 out-of-pocket cap – will phase in by 2026. These provisions will improve seniors’ access to health care, strengthen the Medicare benefit, and save seniors money over the long term.

The Inflation Reduction Act’s provisions to reduce seniors’ costs for insulin and vaccines go into effect in 2023, and I applaud efforts by CMS, ACL, and Part D Plan Sponsors to help seniors take full advantage of these new benefits during open enrollment this year. For example, now that insulin co-pays are capped and many vaccines available without co-pay, many seniors enrolled in enhanced plans with higher premiums may be able to choose alternative plans with no change to their insulin or vaccine benefit. The new cap and benefit enhancements apply to all Part D enrollees, including Low-Income Support beneficiaries.

These policy changes will make a real difference in seniors’ annual costs and their access to health care starting next year. In 2020, the average senior spent $54 out-of-pocket on each insulin prescription – more than 50% higher than the new $35 monthly out-of-pocket cap. For other insulin products, seniors currently pay as much as $120 on each prescription.  For many seniors the retail cost of the two-dose shingles vaccine could be as high as $162 per shot – the new law makes it available to Part D enrollees without co-pay in 2023. Nearly 85,000 Virginian seniors received a vaccine through Medicare Part D in 2020 and could see their cost-sharing reduced by this provision.

I also recognize that State Health Insurance Assistance Programs (SHIPs) will play an invaluable role in helping seniors take maximum advantage of the Inflation Reduction Act’s new benefits. SHIP counselors provide community-based assistance to millions of seniors by helping them understand their Medicare benefits and their options during open enrollment. SHIP counselors are adept at handling the most complex enrollment issues and spend more time per session with beneficiaries than the Medicare call center. I welcome the chance to work with ACL to ensure SHIPs have the funding and resources they need to meet the challenge.

I reiterate the importance of Medicare beneficiaries being aware of these improved benefits so they can make an informed choice about the plan that is best for them during this year’s open enrollment and take full advantage of the Inflation Reduction Act’s historic cost savings. Thank you very much for your consideration.

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