Medicare AdvantageCoverageHigh impact
Inflation Reduction Act IRA 2023 Medicare Part D Changes
Medical Mutual of Ohio·In the News
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
The Inflation Reduction Act creates two significant Medicare Part D changes for 2023: all covered adult vaccines will have $0 copay for members regardless of deductible status, and insulin costs are capped at $35 per month maximum. Both changes apply across all Part D coverage stages without deductible requirements.
Action Required
Immediately: Billing team must verify Medical Mutual Medicare formularies to identify vaccines marked '$0 Vax' and insulins marked '$35/Mth' in Requirements/Limits column. Update patient cost-sharing calculations in billing system to reflect $0 vaccine copays and $35 maximum insulin costs for Medicare Part D members. Train front desk staff to inform patients of new lower costs to prevent payment collection errors.