Reducing Drug Prices for Seniors Act

Lower drug coinsurance for Medicare seniors

If enacted, starting with plan years that begin on or after January 1, 2026, your Part D coinsurance would be figured differently. For formulary drugs that use coinsurance (not a flat copay), your plan would use its net negotiated price when it is lower than the wholesale price. That net price means the price after manufacturer discounts. This would only apply after you meet the plan deductible and before you hit the annual out-of-pocket limit. It would not apply to drugs excluded under paragraphs (8) or (9). This could lower what you pay for some drugs in Medicare Part D or MA-PD plans.