In 2024, Medicare expenses and coverage will be changed. The Medicare changes, which were announced just in advance of the yearly open enrollment period, which runs until December 7, impact both the original Medicare program and Medicare Advantage enrollees.
To begin, Medicare’s over 65 million enrollees will continue to benefit from the revolutionary drug law enacted in 2022, which aims to reduce what older Americans spend on prescription drugs. At the same time, recipients will pay higher rates and deductibles for medical services.
As more individuals (more than half) participate in the Medicare Advantage program (MA), a private healthcare option to the original Medicare, the shape of Medicare keeps changing.
In addition, the Centers for Medicare & Medicaid Services (CMS), the agency in charge of Medicare, will continue its work in 2024 to improve the coordination of care for original Medicare members.
Read on and find out everything you need to know about the Medicare changes.
1. There is a chance that the D premiums will drop
Part D of Medicare is a sort of supplementary Medicare plan that pays for prescription drugs. All U.S. residents who are enrolled in Original Medicare, a Medicare Supplement plan (Medigap), or a private Medicare Advantage plan that does not include a medication prescription benefit are qualified to enroll in a Part D plan.
Medicare Part D plans are handled by private insurance companies that have been approved by Medicare. Annual deductibles, monthly premiums, and prescription expenses differ per policy.
Now, let’s get to the Medicare changes to Part D. According to the Centers for Medicare and Medicaid Services, or CMS, the median monthly cost for a Medicare Part D prescription medication plan in 2024 is expected to be $55.50, compared to $56.49 in 2023. The 99-cent decline is due to policy measures made by President Joe Biden’s Inflation Reduction Act, which was enacted into law in 2022.
Similarly with Part B, around 8% of those with Medicare Part D insurance have to pay an IRMAA that varies from $12.90 to $81 based on the beneficiary’s earnings from two years ago.
2. Premiums and deductibles for Medicare Part B are increasing
Part B of Original Medicare is one of the two primary components and is also one of the parts that are affected by the Medicare changes that take place in 2024. While Medicare Part A covers hospitalizations along with certain home healthcare and hospice expenditures, Part B includes the evaluation and management of health issues, as well as preventative care such as flu vaccines and doctor visits.
Part B of Medicare also covers emergency services, costly medical supplies, limited ambulatory prescription medicines, mental health treatment, and participation in clinical trials.
Most Americans participating in Original Medicare (Parts A and B) or a Medicare Advantage plan will have to pay a regular Part B monthly payment of $174.70 beginning January 1, 2024, a $9.80 (or 5.9%) increase from 2023. The yearly deductible for Part B is also increasing by $14 to $240.
Medicare enrollees whose income exceeds a specific threshold must also pay an earnings-related monthly adjustment amount (IRMAA) that can vary from $69.90 to $419.30—an increase from $65.90 to $395.60 in 2023. Surcharges under IRMAA impact roughly eight percent of those who receive Medicare.
3. More benefits
The majority of Medicare Advantage plans go above and beyond what the law requires. Most commonly, services include some dental, vision, and hearing care; however, memberships to gyms, transportation to doctor appointments, accessibility modifications to residences, and even meals brought to homes can also be included.
According to CMS experts, many Medicare members do not take full advantage of a number of these perks, and sometimes they are not even aware they are eligible for them.
According to a planned regulation, which is anticipated to be implemented in 2024, insurers would need to send letters to those enrolled informing them of the services to which they are entitled but aren’t yet taking advantage.
4. If you suffer from chronic pain, you will have more coverage added
There are many conditions that cause chronic pain, and this means there are also many people who require treatment for this type of pain. From rheumatoid arthritis to fibromyalgia, everyone needs medication, and some of the Medicare changes that will take place in 2024 are targeting exactly those who need to treat these painful conditions.
Beginning in 2024, those with chronic pain (pain that lasts for at least three months) will be able to get insurance for pain control and treatment.
Medicare will start to cover the following services on a monthly basis: pain evaluation, medication administration, planning of care, and coordination. Beneficiaries must pay their Part B deductible as well as the copay for these treatments.
5. Mental health becomes a priority
In 2024, Medicare will also increase access to mental health specialists. Mental health counselors and marital and family therapists have been authorized to enroll as Medicare providers for the very first time. The initiative is aimed at helping beneficiaries who are suffering from depression, anxiety, or substance abuse by increasing the number of specialists who can assist with these problems.
In January, Medicare will also expand its coverage of specialized outpatient mental health treatments. The Centers for Medicare and Medicaid Services state in their “Medicare and You 2024 Handbook” that a beneficiary is liable for 20% of the Medicare-approved amount, in addition to their Part B deductible, for these treatments.
6. The donut hole
Some of the 2024-2025 Medicare changes are all about the Part D “donut hole.”
Medicare prescription medication plans have a coverage gap or a short-term limit on drug plan coverage. This covering void is commonly referred to as the “donut hole.” The donut hole comes in once you and the insurance company have spent a specific amount on meds in total expenditures.
This coverage gap will begin in 2024 when both you and your drug plan spend $5,030 on approved medications, which is more than the $4,660 spent in 2023.
After you have paid the $5,030, you have to pay a percentage of your medicines out of pocket, up to your plan’s out-of-pocket maximum. After gaining this level, you will not pay more than 25% of the total medicine prices (trademarked and generic), regardless of whether you purchase your prescriptions at the pharmacy or online.
When you go above that limit, your coverage resumes. You join the emergency coverage phase after you have reached your out-of-pocket limit for covered medications ($8,000 in 2024). This phase ends in 2024, when cost-sharing for covered medications will be eliminated.
When changes happen, the best thing to do is to prepare yourself. This is why it is good to know about the Medicare changes in advance. In this way, you can get ready and have the best strategy.
As you can see, many things will not be as they used to be, and we hope that everything you have read in this article will help you. If you know any tips that might help, share them in the comments.
If you want to learn more about Medicare, this book might help you: 10 Costly Medicare Mistakes You Can’t Afford to Make
You should also read: 13 Ways to Manage Diabetes: Seniors Edition