Medicare rebate becomes available for 750,000 Americans

More than 750,000 Americans could now get a Medicare rebate this month as the federal government starts offering savings on prescriptions for 64 different medications on Medicare Part B.

The Medicare rebate program first became available Monday, July 1, and it will continue to be available until September 30. Approved as one element of the Inflation Reduction Act, the Biden administration passed the rebates to lower costs of drugs and keep prices manageable during high inflation.

More than 750,000 people on Medicare use the medications covered by the rebate yearly for conditions for everything from osteoporosis to infections and cancer.

All of the Medicare Part B drugs are typically used as “outpatient” medications via an IV instead of drugs you take directly at home after getting a prescription.

Everyone who is already on Medicare Part B is eligible for the rebate and will start seeing beneficial rates this month until September.

“Individuals with Medicare Part B coverage may see lower coinsurance payments for these drugs starting July 1,” an HHS spokesperson told CNET. “No action is required from enrollees to benefit from this rebate.”

Chris Fong, a Medicare specialist and CEO of Smile Insurance Group, echoed that directive, saying all Part B recipients will start noticing the lower prices taking effect in July.

“If there is anyone who is taking one of these medications, they do not need to do anything,” Fong told Newsweek. “The rebate should be applied at the claims processing stage and Medicare members do not need to make any active steps to ensure the rebates are applied.”

Alex Beene, a financial literacy instructor at the University of Tennessee at Martin, said the rebates are a key part of the Inflation Reduction Act and help one of the most devastated groups from the effects of inflation: seniors.

“With the costs of many daily expenses increasing dramatically, it’s become more and more difficult for them to survive just based on Social Security and any other retirement savings they may have accumulated,” Beene told Newsweek.

“This expansion of what Medicare will cover and offer rebates for will be a game changer for many seniors who have had trouble being able to pay for medical expenses in addition to every other expense they have.”

Seniors on Medicare Advantage were also alerted they may end up with faster prior authorization times now that a bipartisan group of senators proposed the Improving Seniors’ Timely Access to Care Act.

“Older Americans shouldn’t be forced to wait to get critical care because their providers are busy dealing with a mountain of paperwork,” said Sen. Tim Kaine (VA-D). “This bipartisan legislation would streamline health care processes to ensure that Americans covered by Medicare Advantage can access the care they need more quickly and enable doctors and health care providers to direct more of their time to their patients.”

Today, most Medicare Advantage beneficiaries often have to wait seven days for a standard medical order to receive prior authorization, while expedited orders can take as long as 72 hours. If the new bill went through, those times could be much shorter.

“I think the bill has a very good chance of being passed,” Fong said. “Some potential arguments by insurance companies would be the additional cost to implement the electronic request process and the additional staff that will be needed to process the prior authorizations within the shorter timeframe.

“If the time frame were to be decreased by half for standard and expedited, it can be argued that the insurance company will need to potentially double their prior authorization team.”