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Keeping Premiums Low for Medicare Part D Beneficiaries


Prescription drug rebates are a cost-savings tool used by Pharmacy Benefit Managers (PBMs), in Medicare as well as other health care markets to keep costs low for patients. While drug manufacturers alone set drug prices, PBMs leverage competition across manufacturers to reduce enrollee premiums and to keep down the cost that consumers pay for their prescriptions. Indeed, almost universally across Medicare Part D, rebates are passed through to plan sponsors and used to enhance benefits or to reduce beneficiary premiums.

As a result, Part D monthly premiums have remained affordable. The Biden administration wisely delayed the rule’s implementation, but if the rebate rule is not repealed, the affordable premiums that beneficiaries have relied upon will rise. The Centers for Medicare and Medicaid Services estimates that the rule will increase premiums for seniors by as much as 25 percent – the largest average premium increase in the history of Part D.

Allowing the rebate rule to proceed is rolling the dice with Medicare beneficiaries’ access to needed medications. The cleanest path forward to avoid severe disruption to Part D, caused by jarring monthly premium increases, is for Congress to quickly repeal the rebate rule outright. To learn more about the importance of rebates, or how PBMs are #OnYourRxSide, click here.

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Pharmacy benefit managers (PBMs) are your advocates in the health care system, working to lower out-of-control prescription drug costs for patients across the country.

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