Latest news with #drugcoverage
Forbes
3 days ago
- Business
- Forbes
Let's Preview 2026 Medicare Part D Premiums, Costs; Prepare To Pay More
The Centers for Medicare and Medicaid Services has started releasing information about the 2026 costs and changes to Medicare. One of the first notices addresses Part D prescription drug plans. Five facts apply to most Medicare beneficiaries who have this Inflation Reduction Act limits the increase in the base premium to 6% and that is exactly how much it will increase next year. This premium factors into what enrollees pay but plans determine their specific premiums. It's unlikely anyone will be paying $ who go more than 63 days without creditable prescription drug coverage pay a penalty for the life of Part D coverage. It is 1% of the base premium, $0.3899 in 2026, for every month Part D enrollment was delayed. An example: A person who did not enroll for three years will pay an additional $14.40 (rounded to the nearest dime) every month. That's $1.15 more per month than in $25 increase is less than the $45 that happened this year. Plans can charge any amount up to the standard deductible.A quick review will help explain this change. With the introduction of the $2,000 cap on Part D drug costs in 2025, CMS feared there would be significant increases in Part D premiums. In response, CMS conducted a voluntary premium stabilization demonstration. This demonstration applied a $15 reduction to the base beneficiary premium and limited premium increases to $35. In 2026, the subsidy will continue; however, it will be $5 less than this year. Premium increases will be limited to $50, up from $35 in 2025. Those with Part D plans will likely face sticker shock. This likely won't happen to those with Medicare Advantage plans. The government provides subsidies in the form of rebates. In 2025, plans received more than $500 per enrollee to lower or reduce Part D premiums and offer supplemental Part D benefits. Over 75% of enrollees pay no monthly premium for their Medicare Advantage plans with no or lower drug plan is a bit of good news amidst all the cost increases. The most anyone will pay for covered Part D drugs from an in-network pharmacy will increase $100 from year, I repeatedly said the Open Enrollment Period would be the most important ever. And once again, in January, I heard from those who did not pay attention. They were stuck with higher costs that could have been avoided had they followed my advice. In about seven weeks, plans will send out the Annual Notice of Changes. Please open and review that closely. Then, take the time to check out what other plans have to offer. And, if Medicare Advantage looks attractive, go beyond the drug plan premium to determine how that coverage will work for you.
Yahoo
21-07-2025
- Health
- Yahoo
B.C. NDPers try to cast themselves as the good guys in reversal over pricy drug
VICTORIA — NDP MLA Ravi Parmar was quick to claim a share of the credit last week for restoring drug coverage for Charleigh Pollock, the 10-year-old Langford girl ravaged by a rare terminal disease. 'From the very first day Charleigh's family reached out, my office and I have advocated for her as we do for all constituents, with respect, compassion, and in confidence,' the Langford-Highlands MLA wrote Friday on his social media account. That was not the view of Charleigh's mother, Jori Fales, who led the fight on the girl's behalf since the threat to cut off her coverage materialized back in February. 'He (Parmar) called once in February when we started our appeal,' Fales said on social media. 'There's been no communication since February except when I emailed Mr. Parmar June 27 asking for his urgent help. 'He responded saying he was glad I'll have the opportunity to meet with Josie Osborne,' he said, referring to a meeting with the health minister on July 4. The public record discloses little other evidence to support Parmar's claim of 'steadfast' advocacy over the six months. When he did weigh in, it was mostly to repeat the government line that decisions on funding expensive drugs for rare diseases — like Brineura, the only treatment for Charleigh's Batten disease — must be left up to the 'medical experts.' Parmar's most recent posting said 'the medical experts who reviewed this case agree: sadly, at this stage of Charleigh's disease, Brineura no longer offers a clinical benefit.' That claim was disputed by numerous experts in Batten disease, something the government finally acknowledged in restoring funding last week. Perhaps the key to understanding the victory lap Parmar took Friday was the claim that his advocacy was undertaken 'in confidence.' Publicly he echoed the premier and the health minister about not overruling the province's hand-picked medical experts. But all the while, he was fighting the good fight on Charleigh's behalf behind the scenes — or so he'd have us believe. 'The case involving Charleigh Pollock has been one of the most difficult I've faced in my many years of service to my community,' said Parmar. 'It is complex, emotional, and at its core, heartbreaking.' Almost as if he were the victim, no? Parmar's self-serving statement might placate some gullible NDP supporters. But for those wondering how the NDP picked a fight it could not win with an ailing 10-year-old, consider the widespread silence of New Democrats on an issue where they knew their government was wrong, wrong, wrong. Nor was Parmar's claim that he'd always been there for Charleigh and her family the most preposterous utterance in this affair. That nod would go to Premier David Eby, when he defended the system that led the province to cut off funding for the only medication that could mitigate the severe seizures associated with Batten disease. 'These are profound and awful decisions that have to be made by experts and physicians and not by politicians,' Eby told reporters last month. 'It doesn't make any sense for that family. I recognize that. But I also recognize that the other course is, if I can say it — is actually worse.' No, you can't say that. Not when the premier's initial deference to provincially selected experts relegated Charleigh's family to raising money over the internet to pay for the one drug that offered the little girl relief in the time she has left. As for Parmar, he may be in line for another kind of relief in his capacity as minister of forests. His mandate letter from the premier directs him to 'work toward a harvest of 45 million cubic metres per year,' from provincial forests, a 50 per cent increase over last year's harvest. The target was discounted as unlikely to be achieved, owing to permitting, regulations, Indigenous approvals and other obstacles. Finance Minister Brenda Bailey signalled her doubts in the provincial budget, forecasting a status quo timber harvest of 30 million cubic metres this year and next, followed by a reduction to 29 million in 2027. Now recent events on the trade front may provide Parmar with an out. Premier David Eby and Prime Minister Mark Carney both said last week that Canada may be able to settle the long-running softwood lumber dispute with a quota system. Canada would try to head off or reduce tariffs — currently 14.38 per cent and headed for 34.45 per cent — by capping soft lumber exports to the U.S. Parmar was quick to embrace the quota option. 'It just may be able to address this issue once and for all,' the forests minister told Mark Page of Black Press Media last week. Then again, 'the president seems to really like tariffs and, so, he may say, bugger off,' Parmar acknowledged. Still, the quota option could provide Parmar with an excuse for giving up on the 50 per cent increase in harvesting. B.C. supplies about 40 per cent of this country's lumber exports to the U.S. and would presumably have to absorb its share of any cap on exports. The cap would in turn reduce the need for any increase in harvesting. vpalmer@ Related Self-styled 'progressive B.C. government' picks fight with 10-year-old that it couldn't win B.C. backtracks and restores rare drug coverage for 10-year-old Charleigh Pollock
Yahoo
12-07-2025
- Health
- Yahoo
Health minister says funding of medication for B.C. girl's rare disease denied again
A Langford family that was hoping the province would reverse its decision for drug coverage to treat their daughter's rare disease is angry after coverage was refused for a second time. The minister of health says an independent medical committee that examines these rare drugs has determined the drug, which costs about $1 million a year, will no longer help the girl's condition. Meera Bains reports.
CTV News
18-06-2025
- Health
- CTV News
B.C. government won't fund drug for 9-year-old with rare disease
Charleigh Pollock poses on a field trip with her classmates on June 13, 2025. VICTORIA — The British Columbia government says it will no longer fund an expensive drug for a nine-year-old girl who has a rare and terminal condition. Health Minister Josie Osborne says in a statement that Charleigh Pollock's condition with Batten Disease has reached the point where she meets the criteria to discontinue the use of Brineura. The girl has been receiving the drug therapy since 2019 at a cost of about $1 million a year. Related: B.C. to cut off drug treatment for 9-year-old girl with rare disease She is the only person in the province, and one of 13 children in Canada, who has the genetic and fatal disorder that results in multiple seizures a day. The statement says clinical evidence shows that once a patient has declined in motor skills and language functions by a certain amount, the drug is no longer a benefit in slowing the progression of the disease. Osborne says a Canada Drug Agency review of the latest research on the girl's disease found there was no evidence to support its continuing drug coverage, given the advanced stage of her condition. This report by The Canadian Press was first published June 18, 2025.
Health Line
12-05-2025
- Health
- Health Line
Part D Late Enrollment Penalty
You can sign up for a Medicare Part D drug plan when initially eligible for Original Medicare. There's a 3-month period starting when your Medicare parts A and B become active. During this time, you can enroll in Medicare Part D without a late enrollment fee. Your monthly Part D premium includes a late enrollment penalty if you miss this time frame. This penalty is 1% of the average monthly prescription premium cost for each month you delay enrollment. In total, this works out to 12% annually. How does Medicare calculate my Part D late enrollment penalty? Medicare determines the late enrollment penalty by taking 1% of the national base beneficiary premium, which is $36.78 in 2025, and multiplying it by the number of months you spend without coverage. Then, Medicare rounds this amount to the nearest 10 cents and adds it to your Part D monthly premium. Medicare recalculates this amount annually using the base premium amount for that year. How long do I pay the Medicare Part D late enrollment penalty? This additional charge is permanent, and every monthly premium includes it for as long as you have Medicare Part D coverage and don't enroll in a Medicare drug plan when you initially become eligible for Original Medicare. You also incur it if you're eligible for Medicare and go 63 days or longer without creditable drug coverage. Once you enroll in a Medicare drug plan, the plan can inform you of your premium amount and whether a penalty is applicable.
