Be Informed: Beneficial Medicare Changes

Brian Connell

Cancer related costs can be an overwhelming burden for patients on Medicare. However, new changes in Medicare will directly impact cancer patients and ease this financial burden.

In this episode, Brian Connell, the Vice President of Federal Affairs at LLS, discusses the new changes in Medicare for 2024 and 2025, as a result of the recent Inflation Reduction Act. Medicare recipients will benefit from these important changes, making cancer treatment more affordable and accessible.

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  1. Thank you so much for helping patients understand the changes coming in on 2024 and 2025! It’s a fabulous news!

  2. I appreciate the concern and care LLS has for patients. It is so encouraging to know that resources are available and there is help finding and utilizing them

  3. Does it matter if I am on Original Medicare Part D or if I am on a Medicare Advantage Plan?
    Michael M

  4. As someone who has been struggling with my upcoming retirement and exteme concern regarding payments for my CML medications it is great news hearing about the upcoming changes to Medicare regarding the Inflation Reduction Act for 2024 and especially 2025. I can have a clearer picture of what I will be facing and able to plan accordingly. Thank you so much for all of your efforts in making this happen. I very much appreciate all of you that have worked so hard to see this come to fruition. Thank you, Thank you, Thank you!

  5. I cried when you said 40% of patients leave their medicine at the counter

    God bless you for your work on our behalf.

  6. Surviving on Medicare has been difficult. The changes that Brian Connnell described in Bloodlines are welcome news. I have had myeloma for the past 8 years. Given the care of my cancer team at Northwestern Hospital in Chicago, the team has been able to identify a drug regimen that has kept me within a “remission” standard. Nevertheless, the cost of the medications have been significant except for a 1 year reprieve through a grant that paid for the medication for 1 year. Two friends of mine who also taught at Wheaton College in Illinois were diagnosed with myeloma a bit before my diagnosis. They both died within 6 months of discovery. I was told that the new cocktail of drugs I was being offered were a lifeline for me. Had I had myeloma 6 months earlier I would have been in the same position as my friends. So the moral of my story is that though the cost of the drugs has been significant, they were worth the cost and are critical for the on-going needs in our society. I am grateful for the work of LLS and my medical team. While not in Heaven, I am in a heavenly place even now. Thanks.

  7. Thanks so much…without the assistance of LLS I would not be enjoying great health and current total remission from Multiple Myeloma. I still take a drug whose cost is 1000 a month if I had to pay for it. LLS makes a tremendous difference in the lives of those who are battling blood cancers. I could not be more appreciative.

  8. Great podcast! Happy to hear the good news for myself and all of my fellow blood cancer friends pertains to changes next year and after in Medicare Part D. Very informative and appreciate all of the efforts of LLS. I have a question pertaining to my Imbruvica copay. Presently, I’ve had no copay for Imbruvica on my current private insurance plan. Will that continue next year after Medicare kicks in?

    1. Hi Greg,

      Your private insurance plan likely won’t change as a result of the new Medicare changes. This will only affect Medicare.

      Thank you for listening!

  9. I enjoyed the pod cast. Medications for cancers treatment is very high and I am so glad a cap in 2025 is coming to assist the patients with their medications.

  10. Wonderful podcast. Thank you for all you do. I do have a LLS grant and feel so much better about the future cost reductions. Good to know.

  11. I have a question. Will the cap be for all medications used in the fight against cancer? My 77 year old husband was diagnosed July 19, 2023 with Waldenstrom Macroglobulinemia. Needless to say, we are horrified at the $4200 per month copay. Plus an additional $4000 the first month. We are beside ourselves. The first year will be over $50,000 copay. Thus will reduce our retirement savings significantly. Of course, we are stressed. If it’s true about the $2,000 cap, that will relieve our anxiety considerably. The two drugs he will be taking are Ibrutinib and Rituxan. Can you put our fears to rest and tell us that all drug copays, including these two, will be part of the capping? He is on Medicare and has SCAN as his supplemental. We live in California. Thank you so much for giving us a little hope.

    1. Hi Sandra,

      The cap is not dependent on the type of medication. This is similar to the annual out of pocket cap that private insurance has had for many years. So, good things ahead! I hope this helps. Thank you for listening.

      1. Thank you so much for your quick response. One more question. Confirming this cap begins in 2025 rather than 2024. Thank you.

        1. Hi Sandra,

          That’s correct, but I took the snippet out of the transcript about 2024:

          “So, what happens on January 1 of 2024 is patients are able to go to the pharmacy
          counter, fill that drug, and never pay after that kind of trigger for the catastrophic
          program. We’re still waiting on the exact number, what that means in terms of an
          annual cap. But, the projections right now is that would be an annual cap for patients
          of around $3,000. It’s a huge benefit for folks who had been paying $10,000,
          $15,000, etc. to have that capped at around $3,000. But we don’t have the smoothing
          provision. That’s what happens in 2025. So we get part of the way there in 2024 with
          around a $3,000 cap, and then all the way there in 2025 with that $2,000 cap and
          smoothed across the year.”

          If you look in the show notes, there are links to the changes from the Inflation Reduction Act on the CMS page. Hope this helps!

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