Millions of Medicare Enrollees Get Free Vaccines

Women benefit from Rx law

Eliminating out-of-pocket costs for vaccines is especially beneficial to the millions of Part D enrollees who are women, according to another HHS report, published in April.

In 2021, nearly 2 million of the 3.4 million enrollees who received a vaccine under Part D were women, and they paid approximately $133.4 million in out-of-pocket costs for these vaccines, or about $68 per enrollee. Had the law been in effect in 2021, they would have had no expenses, the report states.

Women enrollees are expected to benefit in several other ways from the prescription drug law, which in addition to making certain Part D vaccines free, caps insulin out-of-pocket costs for Medicare beneficiaries at $35 for a month’s supply. According to the HHS report, nearly 733,000 female enrollees were taking insulin in 2020. “The reduction in out-of-pocket spending, in turn, may improve access and adherence to prescribed insulin regimens, which may avert hospitalizations and health care complications associated with uncontrolled diabetes,” the report’s authors write.

In combination with other new benefits, the changes to the Part D benefit design under the law — which includes an annual $2,000 out-of-pocket cap for medications beginning in 2025 — are projected to save women enrollees an average of $128 a year. Some women will have savings of $1,000 or more in out-of-pocket costs, according to the report. Women enrolled in Medicare have higher rates of several serious health conditions that require prescription medication, including asthma, Alzheimer’s disease and autoimmune conditions.

The Medicare drug price negotiations will directly impact older women, too. Under the law, Medicare is negotiating the prices of certain medications directly with their manufacturers — starting with a list of 10, and more drugs will be added every year.

In 2022, more than 4.5 million women took at least one of the first 10 drugs selected for negotiation, according to the HHS report, and women with Medicare shelled out $1.55 billion in out-of-pocket expenses for them. The negotiated prices for the first 10 drugs will go into effect in 2026.

“The new prescription drug law is already creating huge savings for millions of Medicare beneficiaries. These benefits will only grow as implementation of this historic law continues,” AARP’s Purvis says.