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Helping Seniors Afford Their Insulin


Washington, D.C. – More than 26 million of America’s seniors could potentially benefit from the Trump administration’s recent announcement on premiums for Medicare Advantage plans and insulin costs, according to new data from the Centers for Medicare and Medicaid Services (CMS). In 2021, average premiums each month in Medicare Advantage plans are projected to drop to prices not seen since 2007. Not only will seniors have lower premium costs, but also more coverage options to choose from with over 4,800 plans in Medicare Advantage. Additionally, more than 1,600 plans will cap insulin copays at $35 a month. This is thanks to the innovative Part D Senior Savings Model for 2021 put forward by the Trump administration.

When President Donald Trump made the announcement on insulin costs earlier this year, Energy and Commerce Committee Republican Leader Greg Walden (R-OR), Oversight and Investigations Subcommittee Republican Leader Brett Guthrie (R-KY), and Health Subcommittee Republican Leader Dr. Michael Burgess (R-TX) said in a statement, “We applaud President Trump for working to make insulin affordable for seniors through a market-based solution. While Speaker Pelosi continues to push for price controls that would make fewer treatments and cures available, the president is bringing all stakeholders to the table to do what’s best for America’s seniors.”

Through hearings and letters to PBMs, drug manufacturers, and insurers, members of the Energy and Commerce Committee have worked to lower the cost of insulin and other life-saving medicines. While there is still much work to be done – another reason why Congress should pass the Lower Costs, More Cures Act – seniors are already benefiting from the work done by the Trump administration to lower their health care costs.

Read more about this win for seniors who rely on insulin below:

Inside Health Policy
One In Three Medicare Advantage Plans Will Cap Insulin Copays At $35
By Ariel Cohen
September 30, 2020

More than 1,600 of the roughly 4,800 Medicare Advantage plans will cap monthly insulin copays at $35 as part of a demonstration that will start in January, CMS said Sept. 24.

The Medicare demonstration, announced in March, limits seniors’ monthly out-of-pocket costs for insulin.

The demo applies to plans that offer more generous drug coverage than basic drug plans, and it’s designed to have a minimal impact on premiums. Enhanced plans may offer fixed dollar copays, instead of charging beneficiaries a percentage of drug prices. Enhanced plans have higher premiums. In 2020, the average monthly Medicare premium was $32.09 for basic drug plans and $49.32 for enhanced plans.

The $35 copay applies during the deductible, initial coverage phase and coverage gap of Part D.

Insulin has come to epitomize fast-rising drug prices, and the drug has received much attention from lawmakers and the administration.

CLICK HERE to read the full article.

Health (116th Congress)
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