PAN Foundation Celebrates Medicare Reforms, New Health Protections for Millions

The PAN Foundation (@PAN_Foundation) is celebrating after the president signed four key Medicare reforms into law through the Inflation Reduction Act, legislation that will make prescriptions and vaccines more affordable for 49 million people with Part D coverage.

The legislation includes, for the first time, an annual limit on what Medicare beneficiaries pay out of pocket for their prescription medications. Beginning in 2025, people on Medicare will spend no more than $2,000 per year out of pocket for their prescription medications and they will have the option to pay monthly, tandem provisions commonly referred to as “cap and smoothing.”

For years, PAN has advocated for these commonsense reforms to make prescriptions and vaccines more affordable for people with Medicare Part D insurance. Though Medicare helps adults afford their healthcare, for many—especially those with a serious illness—the out-of-pocket costs are often prohibitive, totaling in the thousands or even tens of thousands. Half of all people with Medicare have incomes below $30,000, and till now, Medicare beneficiaries have been the only insured group in the U.S. who were not protected by an annual limit on their out-of-pocket responsibilities.

The bill signing ceremony was the final step to enact these health provisions after the Senate and House voted to pass the Inflation Reduction Act last week. With Congressional approval and President Joe Biden’s signature, greater access to care and financial relief is possible for the 49 million older adults and people with disabilities who rely on Medicare Part D for their prescriptions.

The law signed includes:

• An annual limit of $2,000 on out-of-pocket costs for people with Medicare Part D
• An option to pay costs monthly, smoothing out the financial burden throughout the year for people with Medicare Part D
• An end to vaccine co-pays for people with Medicare Part D
• An expansion of the federal Extra Help program, allowing more people in need to qualify for financial assistance

“Today marks a huge step toward expanded healthcare access. These four Medicare reforms will mean grandparents don’t have to choose between groceries and prescriptions. They will mean that the price of a vaccine won’t stop someone with a chronic condition from getting immunized,” said PAN President and CEO Kevin L. Hagan. “Ultimately, they mean improved health outcomes for 49 million people. This legislation will change lives.”

PAN’s Executive Vice President Amy Niles, who leads public policy and advocacy initiatives, echoed his enthusiasm for these reforms.

“PAN has advocated for these Medicare improvements for years, and we are thrilled to see them enacted into law, particularly the annual cap” she said. “I’d also like to thank the PAN advocates who sent tens of thousands of emails to their elected officials over the last few years sharing the impact these reforms would have on their health and lives. Today, their voices have been heard.”

The PAN Foundation has long advocated for cap and smoothing for Medicare Part D and other patient-first measures. Read about our advocacy work.

About the PAN Foundation
The PAN Foundation is an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic, and rare diseases with the out-of-pocket costs for their prescribed medications.

Since 2004, we have provided more than 1 million underinsured patients with $4 billion in financial assistance. Partnering with generous donors, healthcare providers and pharmacies, we provide the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life.