CMS lowers cost of prescription drugs for Medicare beneficiaries

The Centers for Medicare & Medicaid Services (CMS) finalized policies for the 2019 Medicare health and drug plans. Early estimates indicate that the plans will provide savings for beneficiaries on prescription drugs while offering additional choices of plans.

CMS is finalizing a reduction in the maximum amount that low-income beneficiaries will pay for certain innovative medicines known as “biosimilars”. The summary listed below outlines the areas of cost savings of prescription drugs:

  • Allowing for certain low-cost generic drugs to be substituted onto plan formularies at any point during the year, so beneficiaries immediately benefit and have lower cost sharing.
  • Increasing competition among plans by removing the requirement that certain Part D plans have to “meaningfully differ” from each other, making more plan options available.
  • Increasing competition among pharmacies by clarifying the “any willing provider” requirement, to increase the number of pharmacy options that beneficiaries have.

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