Part D

I heard that there is a new law that is helping to reduce prescription drug costs for people on Medicare. How could this law affect my out-of-pocket costs under Medicare Part D?

Yes, there is a new law that helps you lower your out-of-pocket costs under Medicare Part D, depending on which drugs you take and whether you have very high drug costs. Beginning in 2023, cost sharing for insulin is capped at $35 per month per prescription and you no longer have to pay any cost sharing for adult vaccines covered by your Part D plan, such as the vaccine for shingles. Also beginning in 2023, the price of drugs you take will increase no more than the rate of inflation from one year to the next. Starting in 2024, your annual out-of-pocket drugs costs will be capped. In 2024, you will no longer have to pay 5% coinsurance if your drug costs exceed the catastrophic coverage threshold, which will be approximately $3,250 in out-of-pocket costs that year. In 2025, your out-of-pocket costs will be capped at $2,000. The amount of the cap will increase in future years based on the rate of growth in annual drug spending under Part D.


While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270 | Email Alerts: | |

The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.