Anticipated Changes for Medicare in 2024

Anticipated Changes for Medicare in 2024

Medicare continues to expand its covered medical services while attempting to maintain affordable pricing for coordinated care among doctor and hospital visits, prescriptions, lab tests, imaging, and more. But each year, millions of enrollees are faced with premium and deductible increases.

In 2024, Part B premiums will rise from the 2023 cost of $164.90 to $174.70-a change usually reflected as a deduction from a person's Social Security check.
Part B deductibles will also increase from $226 to $240. However, a recent Social Security cost-of-living increase of 3.2 percent, an increase of $59 on average, will offset the additional expenses.

Part A monthly premiums are subsidized for those who have worked long enough to qualify for coverage. For those who have not, the deductible will increase by $32, going from $1,600 per stay in 2023 to $1,632 per stay in 2024. Part A coverage is mainly for in-patient hospital care, short-term skilled nursing facility care, hospice, and home health care.

For those with higher incomes-over $103,000 annually-premiums are higher than the standard and depend on earnings. About 8 percent of enrollees are affected by this higher premium calculation.

These changes are relatively minimal, but there are more.

The Shift to Part C Medicare Advantage Plans

Medicare Parts A and B are part of the traditional (original) Medicare plan, and many people are shifting from their original plans to private Part C Medicare Advantage (MA) plans. Insurers are now required to add outpatient behavioral health coverage to MA plans, such as marriage, family, mental health, and addiction counseling. Plans may also include some dental, vision, and hearing coverage, along with gym memberships, transportation, accessibility, and meal services.

Providers of MA plans must also remind people of their available benefits that have yet to be used by the middle of their plan year. Each plan uses preferred provider organizations (PPOs) and health maintenance organizations (HMOs), believed to be more efficient when coordinating care between medical professionals.

The trade-off for expanded services and convenient coordination of care is having to choose physicians who participate in the network or else having to pay a higher price for services. The cost for these plans may also exceed the Part B premium for original Medicare, depending on the plan and where you live. However, some insurers may cover the additional charge as a "giveback" benefit. If you have a lower income, you may want to learn more about this from a local insurance company or agent.

The Future of Original Medicare Part A and B Plans

The Centers for Medicare & Medicaid Services (CMS) is working on improving the coordination of care for original Medicare plan recipients to increase quality and reduce costs by 2030. Accountable care organizations help medical professionals offer better care for patients with more complex illnesses and develop training programs for family members caring for loved ones at home. Keeping people comfortable at home for as long as possible is one of the best ways to reduce the burden on the US healthcare system-and a growing population of aging retirees prefer it.

What's New for Part D Prescription Plans

The Social Security Administration's Extra Help Program is designed to help people with low income and limited resources pay for rising prescription costs, and it is loosening its eligibility requirements. Previously, the income limit was based on 135 percent of the federal poverty level (FPL). The income limit is now at 150 percent of the FPL, which is $21,870 for an individual and $29,580 for a married couple. Asset limits are $16,600 for an individual and $33,240 for a married couple. These numbers will change slightly when updates for 2024 are released in February.

The catastrophic cap for Part D prescription drug expenses in a year is set at $8,000. Once this limit is reached, there are no more out-of-pocket costs for the rest of the year. In 2025, this cap will be reduced to $2,000, resulting in significant savings for those with chronic illnesses. The following changes from the 2023 Medicare and the Inflation Reduction Act will continue to improve the Part D program:
  • A $35 cap on 30-day supplies of Medicare-covered insulin for both MA plans and standalone Part D plans
  • Free adult vaccines recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, including shingles, RSV, flu, COVID-19, pneumonia, hepatitis A, rabies, and tetanus
  • Drug prices that rise more than the general inflation rate receive a rebate from Medicare (64 drugs currently qualify)
  • In September 2024, CMS will begin publishing a list of the first 10 drugs that must negotiate a maximum for fair pricing

Medicare Enrollment

There are currently 65 million enrollees in the Medicare program, most of whom are retirees aged 65 and older. Others may qualify earlier if they are disabled, have permanent kidney failure, or have ALS (Lou Gehrig's disease). When qualifying and applying for coverage, the options for plans and services can be overwhelming. It may be hard to accurately compare plans and know which benefits will effectively meet your needs, and your needs may change from year to year. If you have a low income, chronic conditions, and multiple prescriptions, seeking the help of professionals is critical. Contact an elder law attorney and insurance agent for advice.