Every year, Medicare makes changes to its costs and covered benefits. As a Medicare beneficiary, you will be paying higher premiums and deductibles in 2024. However, there are also some positive changes, such as continued cost savings for prescription drugs as well as expanded coverage for some services, including mental health.
How these cost changes impact you will depend on several factors, including your income level, whether you pay a penalty for late enrollment, and whether you have Original Medicare or a Medicare Advantage plan.
Part A and B Premiums
Part A Premium – Most Medicare recipients qualify for premium-free Part A if they or their spouse worked at least 10 years (or 40 quarters). If you worked fewer than 10 years, you will pay either $278 or $505 per month in 2024, depending on your work history.
Part B Premium – The standard Part B premium is $174.70 in 2024 – an increase from $164.90 in 2023. Certain beneficiaries may pay more, based on their income.
Deductibles and Coinsurance
Medicare Advantage – If you have a Medicare Advantage plan, your insurance carrier determines your monthly plan premium, deductibles, copays, and coinsurances, which means these can change every year.
Original Medicare – If you have Original Medicare, Medicare sets your Part A and B deductibles and coinsurances every year. If you have a Medicare Supplement plan, you’ll see a reduction to some of your out-of-pocket costs.
Benefit Changes for 2024
The type of Medicare coverage you have determines what you pay for your prescription drug coverage and your medical benefits. Out-of-pocket costs (such as deductibles, copays, and coinsurances) depend on your coverage.
Savings on Medications
No matter if you have your Part D drug coverage through a Medicare Advantage plan or a stand-alone prescription drug plan, these changes will impact you.
The Inflation Reduction Act of 2022 continues to protect Medicare beneficiaries against rising drug prices, beginning with the $35 insulin cap in 2023. In 2024, you can also expect:
- Elimination of the Catastrophic Phase of the Coverage Gap – If your out-of-pocket Part D drugs costs reach $8,000 in 2024, you will have no more out-of-pocket expenses for the year. This eliminates the 5% copay in the catastrophic phase of the coverage gap, also known as the donut hole. In 2025, the Inflation Reduction Act will cap annual Part D out-of-pocket expenses at $2,000.
- Protection Against Inflation – You might pay less out of pocket for certain Part B drugs if manufacturers increase prices higher than the rate of inflation. These drugmakers will have to pay a penalty to Medicare in the form of a rebate. Each quarter, Medicare will release a new list of drugs subject to the rebate based on inflation. Medicare beneficiaries will pay their 20% coinsurance based on what the price would have been if the price increase had been held to the rate of inflation.
- Extra Help – Medicare’s Extra Help program (which helps low-income beneficiaries afford their prescriptions) has expanded the eligibility requirements to allow more people to qualify. The income threshold has increased to 150% of the poverty level – $21,870 for an individual and $45,000 for a family of four – up from 135% in 2023. You may be among the additional three million people who now qualify for financial assistance to pay for their medications. You can check your eligibility and apply for the program through the Social Security Administration.
Expanding Access to Mental Health
Medicare will expand coverage to include mental health services provided by marriage and family therapists and mental health counselors. It will also cover intensive outpatient program services performed by hospitals, community health centers, federal qualified health centers, and rural health clinics.
Chronic pain management and treatment
Medicare will cover monthly services for pain assessment, medication management, and care coordination for people living with chronic pain for three months or more.
Lymphedema compression treatment items
Medicare will cover prescribed gradient compression garments (standard and custom fitted) for any beneficiary diagnosed with lymphedema.
Provider Change Notification
If you have a Medicare Advantage plan, your insurer must notify you if your primary care doctor or mental health provider is leaving your plan. In addition to this, your insurer must:
- Help you find a new doctor.
- Help you continue necessary care that is already in progress.
- Notify you of any enrollment periods available to you and your options for changing plans.
Do you have questions about your benefits and the impact of the Medicare’s changes in 2024? The experienced team at Healthcare Educators is here to help. Contact us today.