Medicare Part D changes could lead to higher cost sharing: Study

A cross-sectional study found that while the Inflation Reduction Act capped out-of-pocket drug costs for Medicare Part D beneficiaries at $2,000 starting in 2025, many enrollees may still face higher cost-sharing due to changes in plan design. 

The research, published Aug. 18 in JAMA Health Forum, showed that between 2019 and 2025, both Medicare Advantage and Medicare Part D standalone plans saw rising deductibles and a greater reliance on coinsurance for name-brand drugs. 

In Medicare Advantage Plans, the share of enrollees with coinsurance for brand-name drugs increased from 2.5% in 2024 to 27.7% in 2025. For standalone plans, the increase was gradual but persistent. The mean deductibles rose from $295 in 2019 to $490 in 2025, and the prevalence of beneficiaries with coinsurance for brand-name drugs increased from 21.9% to 84%. 

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