This 2021 NCOA issue brief is an update to Make Prescription Drugs More Affordable for Medicare Beneficiaries, where NCOA outlines its priorities for improving Medicare Part D.
NCOA continues to support the establishment of an out-of-pocket (OOP) cap for Medicare beneficiaries in Part D.
Making prescription drugs more affordable for low-income Medicare beneficiaries should be a priority. The Part D Extra Help Low-Income Subsidy (LIS) was designed to address the needs of this particularly vulnerable population, but the program has significant flaws that should be addressed.
The National Council on Aging (NCOA) urges Congress to take action to make prescription drugs more affordable for Medicare beneficiaries who struggle the most with these costs and protect access to needed prescription drugs.
NCOA continues to support the establishment of an out-of-pocket (OOP) cap for Medicare beneficiaries in Part D. In 2021, beneficiaries must pay 5% of their drug costs indefinitely when they exceed the current OOP threshold of $6,550. A hard cap would reduce OOP costs and enhance predictability for the over one million beneficiaries who reach the catastrophic phase each year and do not have low-income subsidies.
Our priority recommendations for improving Medicare Part D are below in our 2021 issue brief, including rationale for a Part D OOP Cap, and what's needed for the Extra Help Low-Income Subsidy (LIS), Appeals and Exceptions, and Pricing Stability.