Health Payer Intelligence September 11, 2023
By Kelsey Waddill

Medicare Part D beneficiaries with HIV will benefit from the out-of-pocket healthcare spending cap and the expansion of low-income subsidy coverage.

The Inflation Reduction Act’s Medicare Part D redesign may improve affordability for beneficiaries with HIV, but stakeholders will need to take steps to ensure beneficiaries get the most out of these cost breaks, an Avalere analysis found.

“The IRA’s Part D redesign provisions aim to reduce affordability challenges and may significantly affect PWH,” the analysis stated. “HIV stakeholders hope that addressing affordability challenges could increase access to antiretrovirals and potentially improve antiretroviral adherence.”

The law, which passed in August 2022 with many major payers’ support, implemented a few changes to out-of-pocket healthcare spending policies and the Medicare Prescription...

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