Key Takeaways

• The $2,000 cap benefits high-spending Medicare beneficiaries, but most face increased costs due to rising deductibles and coinsurance.
• Deductibles in Medicare Advantage and Part D plans have significantly increased, reducing enrollment in zero-deductible plans.  (see chart near by; average annual deductible by plan type)

Copays replaced by coinsurance

At the same time, many plans are moving away from flat copays and instead charging coinsurance — a percentage of a drug’s list price. That shift means patients are now paying a share of the full, often-inflated list price, rather than a fixed dollar amount.

The use of coinsurance in MA plans for common brand-name drugs skyrocketed from 2.6% in 2024 to 27.5% in 2025. Among stand-alone Part D plans, 84.1% of enrollees are now in plans using coinsurance — up from just 9.9% five years ago.

That change can be costly.

https://www.medicaleconomics.com/view/medicare-drug-plans-shift-costs-to-patients-under-ira