Medicare Part D is a voluntary outpatient prescription drug benefit to assist people in affording their prescription medications. Part D benefits are provided through private health insurance plans and approved by the federal government. Participants in Part D are able to choose between supplementing their traditional Medicare with a stand-alone prescription drug plan or a Medicare Advantage prescription drug plan that is part of and includes other aspects of Medicare. In November, 2018 the Centers for Medicare & Medicaid Services (CMS) proposed a new rule for Part D that would have changed the special coverage protections for medications included in the six protected classes.

The Centers for Medicare and Medicaid Services (CMS) have recently released a National Coverage Analysis memo to decide how CMS will provide coverage for this innovative treatment. They have proposed coverage alongside a concept known as “evidence development.”

In November, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would allow for several changes to the protected classes policy in Medicare Part D. The Cancer Support Community is concerned that if these changes are allowed, patients may face barriers to the cancer treatments that are right for them

A new type of policy has been introduced that has the potential to put cancer patients at serious financial risk. You may not have heard of copay accumulators or accumulator adjustment programs before, so this blog will provide an overview of these policies to help prepare you in case you might be at risk of facing this barrier to affordable cancer care.