PANDORA’S BOX EVERYTHING GOT OUT. THE HOPE IS AT THE BOTTOM. |
THE ONE-WAY DOOR Washington has set the price of fifteen drugs, and on January 1 that price is the price A month of Ozempic goes to $274. The part of this still in your hands closes on December 7. |
For nineteen years a law barred Medicare from negotiating the price of a drug. |
A 2022 law removed that bar. |
The first ten negotiated prices started this January. |
Fifteen more start on January 1. |
The familiar name on it is Ozempic. Rybelsus and Wegovy are on it too. |
A thirty day supply is set at $274. |
| $274 A SET MONTH OF OZEMPIC, FROM JANUARY 1 | → | The agreements were signed last November. What is still open is which plan you are in when the prices start. |
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In 2024 about 2,282,000 people on Part D were dispensed one of those three. |
Across all fifteen it was about 5.3 million, out of 53 million. |
The negotiating period closed last November. |
Every one of the fifteen companies signed. |
That part is finished. |
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Now the part still yours to decide. |
Open enrollment runs until December 7. |
After that, the plan you are in is the plan you have for the year. |
So the question this week is narrow. |
Does your plan cover the drug you actually take, and on which tier. |
A negotiated price caps what the plan pays. It is not a promise about your share. |
Your share still depends on the plan you picked. |
Three numbers under it have moved, and all three moved up. |
The standard deductible goes from $615 to $700. |
The base premium goes from $38.99 to $41.33. |
The ceiling on your own spending goes from $2,100 to $2,400. |
Medicare set those in April and July. They are settled. |
Two numbers are not settled yet. |
The Part B premium and the Part B deductible are still estimates. |
The trustees put them near $209.50 and $292. |
Medicare publishes the real ones in mid November. |
Which is after most people have chosen. |
So what does this cost you. |
If you take one of the fifteen, it saves you money. |
Medicare puts the total at $685 million across everyone in 2027. |
If you take none of them, that saving is not yours. |
The higher deductible is. It arrives the same morning. |
A date that is set for you is a different thing from a date you chose. |
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EVERY LEAD PASSES BEFORE IT RUNS The One-Way-Door Test |
01 | Can it be undone? All fifteen agreements are signed and the start date sits in the statute. Only the plan you sit in is still a choice. | |
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02 | Who is already repositioning? The plans are, around the new prices. Your plan’s notice of change for 2027 was due by September 30. | |
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03 | What does being late cost? Missing December 7 costs you the year in that plan. The deductible under the cap rises by $85 either way. | |
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THE MOVE · TWO VERSIONS, PICK YOURS Find the plan letter that arrived in September and read one line in it. The tier your own prescription sits on for 2027. If you take none of the fifteen, one line still matters. What your own premium does next year, because the base rose and plans do not follow it in step. The Part B figures above are estimates until mid November. Most people will have chosen by then. |
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ALSO GOT LOOSE TODAY | The Federal Reserve held rates steady yesterday, in a split vote. | MONEY |
| Amazon reports its third quarter results after the close today. | MACHINES |
| The midterm elections are on Tuesday. | LATER |
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WHAT’S LEFT AT THE BOTTOM The price is written down, in public, with a date on it. Whatever else moves in January, that number will not surprise you. WE WATCH THE BOX. |
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