Home Health and the Inflation Reduction Act of 2022
As home health professionals, we empathize a lot with the high costs of prescription drugs for many of our clients that depend on them.
The Inflation Reduction Act signed by President Joe Biden on 8/16/22 will help in changing that in the following ways:
The most influential part of the recently signed bill on home health services is the new $35 monthly cap on insulin. This is effective January 1 , 2023 for those with Traditional Medicare only, not private insurers, or the Medicare Advantage plans that have gotten more common in home health settings over the last decade.
Medicare beneficiaries now have an out of pocket cap of $2,000 per year on prescription drugs, starting January 2025. Prior, Medicare beneficiaries had to spend at least $7,000 to qualify for any type of assistance with prescription costs. Though a few years off, this is another welcome development as it will save Medicare beneficiaries additional money that can be applied to ease their cost of living.
Last but not least, starting January 2023, seniors on Medicare will not have co-payments on adult vaccines like pneumonia and shingles.
Overall, we at Star Healthcare of Texas are confident that the new bill is a step forward in driving down the often continuously raising ceiling in health care costs to patients. It is also a way to bring many patients who signed up with private Medicare Advantage plans back to Traditional Medicare.
Medicare Advantage plans often seem better to low income/net worth patients, but the Part D (drug coverage) advantages they offer often come with cuts to the home health related Part A and/or B services. This can result in higher copays, less covered services, or outright rejection from home health agencies for patients needing services.
