Part of President Joe Biden’s election year pitch to Latino voters includes a promise to lower health care costs. Online
Starting in 2025"no matter what your total bills are for prescription drugs,” Medicare Part D users will never pay “more than $2,000 a year, because some of these cancer drugs are 10 15,000 bucks a year.”President Joe Biden speaks at an event about canceling student debt, at the Madison Area Technical College Truax campus on April 8, 2024, in Madison, Wis. He also talked about the promise of the semiconductors field.
We found that Biden is largely accurate about the cap’s effect. One caveat is that some expensive cancer drugs delivered in doctors’ offices — as with chemotherapy — are not subject to the cap.One part of the law affects annual out-of-pocket drug costs for enrollees in Medicare, the federal health insurance program for people older than 65, younger people with certain disabilities and people with end-stage renal disease. Medicare’s drug coverage is known as Part D.
Part D is voluntary, but has strong financial incentives to encourage people to enroll when they become eligible, unless they have comparable coverage under another plan, KFF Senior Vice President Tricia Neuman said. That means that the cap doesn’t apply to patients who get an infusion of chemotherapy at a doctor’s office — something Medicare Part B would cover. How much patients pay for chemo over a year varies on their benefits, including the terms of their supplemental coverage or whether they have Medicare Advantage, and how much the patients have spent on other medical services that year.
Email interview, Matthew Fiedler, senior fellow in economic studies at the Center on Health Policy at The Brookings Institution, April 10, 2024
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