Debate: Will Taxpayers Benefit From Medicare's New Prescription Payment Plan?

Expert Opinion October 25, 2024 at 03:21 PM
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Robert Bloink and William H. Byrnes

Medicare's new prescription payment plan is scheduled to take effect Jan. 1. The plan allows taxpayers who have Part D prescription drug coverage to spread costs over the entire year, rather than paying at once. 

Participation in the plan is voluntary, and taxpayers must elect to participate. On the Medicare plan finder, taxpayers can use a link to determine what their costs would be at each selected pharmacy. Eligible individuals will receive a notice from their prescription drug plan.

We asked two professors and authors of ALM's Tax Facts with opposing political viewpoints to share their opinions about the impact of Medicare's new prescription payment plan.

Below is a summary of the debate that ensued between the two professors.

Their Votes:

thumbs up Bloink

Byrnes

Their Reasons:

Bloink: The new plan provides clear and concise information for taxpayers who are struggling to make complex decisions with respect to their prescription drug coverage. As with any new program, there are sure to be kinks. We still have months to work out those administrative issues to ensure that Medicare enrollees are not adversely impacted. The program itself is valuable enough to make it worth the effort as we move toward 2025.

Byrnes: The information that taxpayers receive under this new program can be incredibly confusing and misleading. The paperwork doesn't always tell taxpayers that their plan will pay for absolutely nothing if they visit an out-of-network pharmacy. We have to find a way to clearly communicate drug costs and ensure that taxpayers who elect to use this program understand the importance of finding an in-network pharmacy and understanding whether their prescriptions are covered or not under their plan and with any given pharmacy.

Bloink: The $2,000 cap on out-of-pocket expenses is extremely important for taxpayers who rely on prescription drugs. Still, even a $2,000 financial hit can be incredibly difficult for many older Americans. This new program will go a long way toward helping older Americans who are burdened with sky-high prescription costs going forward.

Byrnes: We have the tools to do better for Americans with Medicare coverage. Under the new plan, what counts as an "in network" pharmacy has changed. Unless these changes are communicated clearly to Americans during this open enrollment season, the potential for confusion is high. We all know that people become set in their ways. It's highly likely that Americans are going to enroll in this payment option as a way to avoid larger financial hits without reading the fine print. 

Bloink: The point of this isn't really to save any money in the long run. The entire premise behind this new payment plan option is to give older Americans another way to ease the burden of prescription drug costs in the event that paying all at once would create a significant hardship. Spreading costs over the entire year is an efficient and effective way to help Medicare Part D enrollees control their finances.

Byrnes: While the plan may not ultimately be designed to save money, we have to expect that many Americans will think that there will be a cost savings associated with the plan. The government has made so many changes with respect to Medicare Part D coverage. It's critical that individuals have the correct information that they need to re-evaluate their options— remembering that many Americans aren't even fully aware of the changes that are occurring. 

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