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Policy & Regulation

What is the Medicare Part D redesign under the IRA?

Starting 2025, the IRA caps Part D out-of-pocket costs at $2,000 annually and eliminates the 5% catastrophic coinsurance. Manufacturers now pay 20% of catastrophic costs (up from 0%). Plan sponsors absorb 60% of catastrophic spend. This shifts approximately $12B annually from beneficiaries and government to manufacturers and plans.