CMS Unveils Sample $2 Generic Drug List for Medicare Part D Enrollees-2027

[Duaine]

But experts are skeptical the list would have much impact.​

The Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a request for information on a proposed model program that would lower prices to $2 per month for certain generic drugs purchased through Medicare Part D drug plans, but experts expressed concerns about the potential uptake and usefulness of such a program.

The model is designed to provide individuals more certainty about the out-of-pocket costs for these generic Part D drugs for common conditions, such as high cholesterol and high blood pressure, CMS said in a press releaseopens in a new tab or window.

"We want generic drugs for common chronic conditions to be affordable for people on Medicare. Reliably low copayments for essential generic drugs make it more likely that seniors and people with disabilities can afford the drugs they need to stay healthy," HHS Secretary Xavier Becerra said in the release.

[EXTERNAL LINK] - CMS Unveils Sample $2 Generic Drug List for Medicare Part D Enrollees

 

[medicare_bid]

But experts are skeptical the list would have much impact.​

The Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a request for information on a proposed model program that would lower prices to $2 per month for certain generic drugs purchased through Medicare Part D drug plans, but experts expressed concerns about the potential uptake and usefulness of such a program.

The model is designed to provide individuals more certainty about the out-of-pocket costs for these generic Part D drugs for common conditions, such as high cholesterol and high blood pressure, CMS said in a press releaseopens in a new tab or window.

"We want generic drugs for common chronic conditions to be affordable for people on Medicare. Reliably low copayments for essential generic drugs make it more likely that seniors and people with disabilities can afford the drugs they need to stay healthy," HHS Secretary Xavier Becerra said in the release.

[EXTERNAL LINK] - CMS Unveils Sample $2 Generic Drug List for Medicare Part D Enrollees

Given that most Medicare plans pay around $0 for the drugs likely to be listed, sounds dumb.

 

[Duaine]

CMS:

 

[just-a-client]

This was baffling - I never paid more than $0 for this kind of drug. Then it occurred to me maybe it's intended to also cover non preferred pharmacies, and maybe even out of network. I guess some people have trouble accessing preferred pharmacies?

Also, where plans apply deductible to all tiers, sometimes these generics can cost more than $2.

 

[InsuranceGuy29]

Given that most Medicare plans pay around $0 for the drugs likely to be listed, sounds dumb.

Just another "brilliant" idea from the Biden/Kamaliar puppets at CMS who don't know their @$$e$ from a hole in the ground, yet these are the people making decisions about our livelihoods. The plans already cover tier 1 and 2 generics unbelievably well. Most are free.

 

[just-a-client]

I guess I'm blocked by a lot of people - which is fair since I'm not an agent.

For the record, I have used a combo BP drug that plans cover in tier 1 ($0 for me) or sometimes tier 2 ($5 for me), where with one of my plans, as listed on the monthly EOB, the retail cost is $39, which the insurer is covering entirely or mostly. That would affect people subject to deductible in Tier 1 or 2.

The $2 drug list includes lots of similar combination drugs but not, unfortunately, that one, but this is just an early proposed list.

The list also includes a drug which at least one of the 2025 plans I've looked at prices at $6.95.

The current $2 drug list is a CSV but opens readably in my browser, so you can check through it - maybe some interesting drugs are included.

https://www.cms.gov/priorities/innovation/files/m2dl-model-rfi-appendix