Inflation Reduction Act Changes to Medicare Coverage

The Inflation Reduction Act (IRA) is federal legislation that went into effect January 1, 2023. The IRA has two updates that affect vaccine and insulin coverage for all Medicare members.

Photo of man speaking to pharmacist.

What Members Pay for Insulin

Medicare members do not pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on. The deductible does not apply for insulin products.

  • 1 month supply of insulin is $35 or less
  • 2-month supply of insulin is $70 or less
  • 3-month supply of insulin is $105 or less

What Members Pay for Vaccinations

Medicare members have $0 cost-sharing for any adult vaccine that is recommended by the Advisory Committee on Immunization Practices (ACIP). Vaccines include shingles, whooping cough, tetanus, and more. ACIP recommends vaccines based on age and medical need. Please consult the schedule for the full list of age-recommended vaccines. The deductible does not apply for ACIP-recommended vaccines.

To learn more:

Visit Medicare.gov/coverage/insulin
Visit Medicare.gov/about-us/inflation-reduction-act
Call 1-800-MEDICARE (1-800-633-4227)

Author
DHMP Staff Writer


The information contained on this blog is intended for informational purposes only. Nothing contained, expressed or implied in this blog, is intended as medical advice nor should it be construed as such. This blog is not a substitute for professional medical advice, medical diagnosis or treatment by a licensed physician or health care provider. It is not meant to and does not cover all possible precautions, drug interactions, circumstances or adverse effects and reliance on the information on this blog is at your own risk. Always talk to your doctor or other qualified health care provider about any concerns or questions you have about your medical care and do not disregard professional medical advice based on the information herein. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.