Passed in August of 2022, the Inflation Reduction Act (IRA) was written to prevent Medicare drug pricing (and other expenses) from getting out of hand due to rising costs. While this act will only address some drug costs right away, its effectiveness will continue to grow over time. In fact, this act will help to reduce the costs of 10 new drugs per year by 2026; by 2029, the Inflation Reduction Act will work to reduce the costs of up to 20 additional drugs per year. More details can be found below.
● January 1, 2023
○ Part D Insulin cost sharing capped at $35 for a one-month supply.
○ Part D Adult vaccines recommended by the Advisory Committee on Immunization Practices shall be covered with no cost sharing.
● April 1, 2023 — Certain Part B rebatable drugs may be subject to a lower coinsurance (the amount you are responsible for after meeting your deductible). A list of the adjusted drugs and their new coinsurance percentages, if covered under Part B, is below. Please note, these changes do not apply to Medicare Part D Prescription Drug Coverage.
Part B Adjusted Drugs & New Coinsurance Percentages
If you have questions about these adjusted costs, please call the number on the back of your SummaCare member ID card.
● July 1, 2023 — Part B covered insulin, insulin administered via a durable medical equipment pumps, cost sharing is subject to a cap of $35 for one-month’s supply of insulin.
HMO-POS (This includes members of our Sapphire (HMO-POS) and Emerald (HMO-POS) plans)
HMO Group (This includes members of our ITW, CNG/Dominion, Lockheed and Summa (HMO) plans)
HMO-POS Group (This includes members of our Catholic Diocese, UFCW and Summa (HMO-POS) plans)
HMO-POS (This includes members of our Sapphire (HMO-POS) and Emerald (HMO-POS) plans)
HMO Group (This includes members of our ITW, CNG/Dominion, Lockheed and Summa (HMO) plans)
HMO-POS Group (This includes members of our Catholic Diocese, UFCW and Summa (HMO-POS) plans)
If you have any questions or need additional information, please contact our Member Services department at 330.996.8885 or toll free at 800.996.6250 (TTY 711).