Cap what Original Medicare patients pay for Part B cancer drugs
Oral cancer drugs under Part D now have a yearly cap of $2,100, but infused drugs under Part B still carry 20% coinsurance with no limit; a Part B cap would close the biggest hole left in Medicare cancer coverage.
Overview
The Inflation Reduction Act capped Part D out-of-pocket spending ($2,000 in 2025, $2,100 in 2026) but left Part B untouched. A patient on an infused checkpoint inhibitor without Medigap or Medicaid owes 20% of the Medicare-approved amount indefinitely. Options include a Part B out-of-pocket cap funded by a premium adjustment, or a guaranteed-issue window for Medigap after a cancer diagnosis so that people can buy the protection that already exists.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
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