January 11, 2023
Notification of Changes in Medicare Part D Program Coverage
HPP is notify you of upcoming changes to Health Partners Medicare’s Part D program coverage. These changes were prompted by the Inflation Reduction Act (IRA), which contains widespread changes to the Medicare program that have taken effect starting in October 2022 and will continue to impact program changes over the next several years.
The following changes will impact your Health Partners Medicare membership in 2023.
- Effective 1/1/2023, the IRA eliminates the deductible and institutes a maximum member cost sharing of $35 per month for all Part D covered insulins.
- Effective 1/1/2023, the IRA implements $0 cost sharing for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
- Effective 7/1/2023, this will also apply to Part B insulin (covered through the DME benefit for use with an insulin pump).
In alignment with the above IRA changes, Health Partners Medicare members will:
- Have no deductible and pay a maximum of $35 for a one-month supply of Part D covered insulins
- Part D covered insulin is any insulin on the Health Partners Medicare formulary and any non-formulary insulin approved through the exceptions or appeals process or filled during the member’s transition period
- This also includes combination insulin products, including Soliqua® and Xultophy®
- Note: The IRA benefits do not apply to supplies associated with the injection of insulin or other diabetes medications that do not contain insulin (i.e., metformin, Trulicity®)
- Will have a $0 copay for Part D covered vaccines recommended by ACIP
- Note: These provisions do not apply to any members aged 18 or younger or any other adult age group not supported by ACIP recommendations for the vaccine
If you have any questions, please contact HPP’s Pharmacy Department at 866-841-7659 and we will be happy to assist you. As always, thank you for providing the highest quality of care to our members.