Medicare Rx Out-of-Pocket Cap Will Benefit Thousands

An AARP report shows an estimated 5.2% of Rhode Islanders on Medicare prescription drug plans will see savings thanks to a new out-of-pocket cap that starts January 1, 2025. The savings are made possible by a provision in the 2022 prescription drug law that AARP championed which caps out-of-pocket prescription drug costs every year, beginning at $2,000 next year, for America’s 56 million Medicare drug plan enrollees.

The AARP report analyzes the number of enrollees who will benefit from the cap by state, age, gender, and race between 2025 and 2029. The findings indicate that Medicare drug plan enrollees nationwide who reach the new out-of-pocket cap will see average savings of roughly $1,500, or 56%, in 2025 for their prescription drugs.

“AARP fought hard for the prescription drug law of 2022 because we knew it would provide crucial relief for Medicare enrollees here in Rhode Island and across the country by lowering drug prices and out-of-pocket costs,” said Catherine Taylor, State Director of AARP Rhode Island, which serves more than 126,000 members age 50 and older in the state. “Knowing they won’t pay a dime over $2,000 next year – maximum – for prescription drugs they get at the pharmacy gives Rhode Island seniors on Medicare drug plans some peace of mind as they struggle to keep up with rising costs for other everyday essentials like housing, groceries and utilities.”

Other findings from the report include:

· Between 3 and 4 million Part D plan enrollees nationwide are estimated to benefit from the new out-of-pocket cap every year between 2025 and 2029, including 9,733 here in Rhode Island.

· By 2029, the share of enrollees benefiting from the new out-of-pocket cap is estimated to be 10 percent or higher in 19 states, including Rhode Island plus the District of Columbia.

· More than three-quarters of Medicare drug plan enrollees who will benefit in 2025 are between the ages of 65 and 84.

“Limiting how much seniors on Medicare drug plans pay for prescription drugs every year builds on other new and important cost-saving measures, such as capping insulin co-pays at $35 a month and making many vaccines, such as shingles and pneumonia, free,” added Taylor.

To learn more about AARP’s work to lower prescription drug prices, visit How High Rx Prices Hurt.