Medicare Is Negotiating Drug Prices: What It Could Mean for You

Why your drug costs could go down

For a long time, Medicare was not allowed to negotiate the prices of prescription drugs. That changed. Medicare can now sit down with drug makers and agree on a lower price for certain medicines.

The new price is called the Maximum Fair Price, or MFP. When a drug has an MFP, the amount you pay at the pharmacy for that drug may be lower.

This matters most if you take a costly medicine for a long-term condition. Lower prices at the counter can mean real savings for people living on fixed incomes.

How the negotiation works

Medicare picks certain drugs that cost the program a lot and have no competition. It then negotiates a lower price with the company that makes each one.

The Centers for Medicare and Medicaid Services (CMS) has released guidance about how drug makers must put these negotiated prices into effect. This is part of the round of negotiation set to apply in 2028.

This is a government program. You do not need to sign up for the negotiation or pay anyone to take part. It happens through Medicare itself.

Who this helps

This helps people with Medicare drug coverage, known as Part D, and in some cases Medicare Part B.

You do not have to do anything special to get a negotiated price. If you have Medicare and you take a drug that has an MFP, the lower price is meant to apply to you automatically at the pharmacy.

The best move right now is to know which drugs are affected and check whether one of yours is on the list. Then you can plan ahead.

Frequently asked questions

Do I have to apply to get a lower drug price?

No. If you have Medicare and take a drug with a negotiated Maximum Fair Price, the lower price is meant to apply at the pharmacy without a separate application. Check Medicare.gov to see which drugs are covered.

Does this cost me anything?

No. Medicare drug price negotiation is a free government program. You should never pay a company to get a negotiated price. Anyone who asks for a fee is not part of the official process.

When do the 2028 negotiated prices apply?

CMS has released guidance for the round of negotiation set to apply in 2028. Check Medicare.gov for the current list of drugs and exact effective dates.

What if my drug is not on the list?

Only certain high-cost drugs are negotiated at a time. If yours is not included now, review your Part D plan each fall and ask your pharmacist about lower-cost options.