Medicare beneficiaries could soon see a dramatic change to their costs in 2022. Earlier this month, Department of Health and Human Services Secretary Xavier Becerra directed the U.S. Centers for Medicare & Medicaid Services to look into lowering the Part B premium from its previously announced monthly amount of $170.10.
Why Could the Premium Change?
According to the Washington Post, this is the first time that Medicare has considered a change to its premiums after announcing its annual figures. But this year’s Part B premium rise – the largest dollar amount increase in program history – has been an unusual situation.
The dramatic increase was largely in response to the uncertainty surrounding new Alzheimer’s drug Aduhelm. The drug, which was approved by the Food and Drug Administration this past summer under controversial circumstances, was set to cost $56,000 for a year of treatment. The National Council on Aging also noted that the drug has yet to show clinically significant evidence that it is effective in treating Alzheimer’s.
Medicare would have been faced with a virtually unprecedented rise in costs if it opted to cover Aduhelm, and that uncertainty was named as a key factor by CMS in its Part B premium rise. But that uncertainty appears to be moving towards a resolution.
Becerra’s directive was in response to Biogen, the company that makes Aduhlem, dropping its cost to $28,200 according to AARP. On top of that price change, Medicare appears to be closing in on a decision to not offer significant coverage for the drug.
According to the New York Times, Medicare is expected to restrict its coverage of Aduhelm to patients who are participating in clinical trials. This would effectively put an end to CMS’ concerns of handling potentially millions of beneficiaries taking a drug that costs tens of thousands of dollars per person.
How Much Will the New Part B Premium Be?
It is currently unclear how much beneficiaries could see their Part B premium decrease if Medicare does opt to make a change to this year’s amounts. But the updated premium could be significantly lower. The annual Medicare Trustees Report, which was released in August and did not account for the potential impact of Aduhelm, projected a Part B increase of just $10 to $158.50.
If CMS opted to return to this previously projected figure, it could save the average beneficiary almost $140 over the course of a year. But there are other factors that could still play a role as well. When CMS originally announced the premium changes for 2022, it also cited several other causes beyond Aduhelm.
Those factors included congressional action that lowered the Part B premium in 2021 in exchange for a bump in costs to future premiums, as well as the typical rising costs across the health care industry that result in higher Medicare premiums each year.
It’s unclear how long it will take Medicare to determine if a change to the 2022 Part B premium will be made. It does not appear that any other Medicare costs for this year are expected to change.