The recently enacted Inflation Reduction Act of 2022 includes provisions that will directly affect the Medicare program and plans across all carriers. These changes will have a direct impact on lowering beneficiary costs and begin in 2023: 

Removal of Cost Sharing on Adult Vaccines   
Medicare beneficiaries will have a $0 cost-share for adult vaccines recommended by the Advisory Committee on Immunization Practices and covered under Medicare Part D, including vaccines such as the Shingrix vaccine for Shingles. Tiering of vaccines won’t change, but beneficiary cost sharing will be eliminated regardless of any published tier copay.  A full list of covered vaccines can be found here. 

$35 Cap on Insulin Cost Sharing for Part D  
All Medicare beneficiaries, regardless of income, will pay a maximum of $35 for a one-month supply of covered insulin products with no deductible. While a $35 cap has been in place for most UnitedHealthcare plans, for 2023 it will be extended to all members across all MAPD and stand-alone PDP plans, including the Walgreen’s and Saver Plus PDPs. The $35 copay maximum will apply in all coverage phases and for all Medicare beneficiaries with Part D coverage. Part B insulin will be covered at the current plan coinsurance through June 20, 2023. It will be covered at the maximum $35 cost share effective July 1, 2023. Pumps are not included in the $35 maximum cost-share. 

What you need to know 

• For Oct. 1, 2022, The Centers for Medicare and Medicaid Services (CMS) is updating Medicare Plan Finder to include new insulin and vaccine drug footnotes and other helpful features to explain the benefit changes resulting from the Inflation Reduction Act.  The cost sharing display will NOT reflect these changes due to timing.
• Because of the timing of this legislation, member-specific changes for 2023 may not be immediately updated in plan materials.  
• Impacted members will be notified directly of the changes.  
• For your reference, revised materials will be posted to the Sales Materials Portal by Oct. 15.  

For more information, please review the Inflation Reduction Act of 2022 FAQ. 

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