What Does the Future Hold for Medicare Part D?

December 20, 2017

Image Credit: Konstantin Shishkin / Dreamstime


It’s basically a given that Medicare is a crucial and complicated issue to figure out, with its many options and different parts. This article will attempt to provide a comprehensive view of Medicare Part D in detail, and examine the current alterations that may be implemented in the near future. What will they mean to a regular Medicare recipient?

Medicare Part D is the segment that provides prescription drug coverage. It is an optional part, which is nonetheless essential for the majority of Medicare recipients, and requires enrollment payments as well as copayment on the actual purchases. Part D is provided by the state rather than federal authorities, and there are usually multiple plans to choose from, the difference between them being in the medical formularies that they choose to cover. These formularies should be essential to a patient’s choice of plan, along with the cost of enrollment, so please compare the lists and prices with great care – they vary dramatically, up to 8 times between the lowest and highest costing plans.

Current challenges

Meanwhile, the need for Medicare Part D is exacerbated by the skyrocketing prices of prescription drugs. According to an AARP (American Association of Retired Persons, a major US non-profit and non-partisan organization that focuses on the lives of 50+ Americans) report, prescription drug prices are rising faster than inflation rates. Even though generic drug prices have been falling steadily, and by as much as 19.4% in 2015 alone, prescription drugs are becoming more and more expensive overall, and between 2006 and 2015 the increase in prices has beaten inflation every time. In fact, 528 most prevalent medications taken daily to control widespread chronic health issues, such as high blood pressure and diabetes, have tripled in price in this time period.

The impact of the price hike will be eventually felt by everyone, even if indirectly, since Medicare and Medicaid programs are financed through taxes. It will also lead to a rise in health insurance premiums, regardless of the age of the insured.

Senior citizens, especially the lower-income segment, are the most vulnerable group hit by the price spike, since Medicare Part D participants pay for 25% of the cost of their prescription medications. What is the current state of affairs? Is there anything that can be done to decrease prescription expenditures at the time when you need it most?

New developments in Medicare prescription drug pricing

First of all, there may be a break coming in the near future, as there is a bill currently introduced to the Congress that, if passed, would require the Secretary of the Department of Health and Human Services to negotiate prices of medications provided under Medicare Part D. This is a long-anticipated move towards the same negotiation process that Medicaid and the US Department of Veterans’ Affairs already undertake. In fact, the supporters of the bill point out that Medicare Part D pays approximately 76% more for brand-name prescription drugs than Medicaid and Department of Veterans’ Affairs. Hopefully, this bill we be passed and signed by President Trump, who has not yet expressed his position on this issue. He had, however, repeatedly stated that pharmaceutical companies are “getting away with murder”, so, hopefully, this is an indication of a positive verdict on his side in regard to the Medicare Drug Price Negotiation Act and Improving Access to Prescription Drug Act, which is another similar legislative proposal currently under consideration.

Current options

  • While the Congress deliberates, there are certain steps to resort to in order to make your Medicare Part D prescriptions more affordable.
  • Discuss switching to generics with your physician;
  • Research your state’s pharmaceutical assistance programs;
  • Find out about pharmaceutical companies’ assistance programs;
  • Learn what additional programs Medicare and Social System offer to limited-income groups of people;
  • Select a plan that offers additional gap coverage (it may be more expensive).


Hopefully, these steps will assist in improving your quality of life and take the unnecessary burden of overpriced medications off your shoulders, while we are all waiting for Medicare prescription drug prices negotiations to begin.

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