Changes are coming to Medicare costs and coverage in 2024. Announced in time for the annual open enrollment period, which continues through December 7, the adjustments affect both Original Medicare and Medicare Advantage beneficiaries.
It’s crucial that enrollees stay informed about each year’s developments. “[Beneficiaries] have to be actively involved in their health care,” advises Darren Hotton, associate director of community health and benefits for the National Council on Aging. Failing to do so can cost you money, he adds.
Read on to learn about the biggest changes to Medicare in 2024 that are worth considering as you look at your plan options for the next year.
Other Medicare Part D Changes in 2024
Beginning in January 2024, Medicare Part D beneficiaries reach the catastrophic coverage level when their out-of-pocket and manufacturer-subsidized drug costs total $8,000. At that point, due to new Medicare rules, they’re no longer subject to a 5% copay. According to one Medicare analysis conducted by KFF, that change caps beneficiaries’ maximum out-of-pocket drug costs at about $3,300 for 2024. It’s projected that out-of-pocket prescription drug costs will then be capped at $2,000 a year for 2025.
Meanwhile, more Medicare beneficiaries are eligible for income assistance to help pay for their health care in 2024. People with incomes of up to 150% of the federal poverty level can qualify for the Part D low-income subsidy benefit. (The 2023 threshold was 135% of the poverty level.) The low-income subsidy program, also known as Extra Help, pays the entire cost of the Part D annual deductible and monthly premium and lower costs for both generic and brand name drugs.
What’s more, beginning in 2024, all adult vaccines covered by Medicare are available for free to beneficiaries. The cost for one month’s supply of any insulin product is also capped at $35.
Expansion of Outpatient Mental Health Services
Medicare is expanding access to behavioral health services in 2024 as well. For the first time, mental health counselors and marriage and family therapists are eligible to enroll as Medicare providers. The move is meant to help beneficiaries coping with depression, anxiety or substance use disorders by making more professionals available to provide care.
Medicare is also extending its coverage of intensive outpatient programs for mental health come January. In its Medicare and You 2024 Handbook, the Centers for Medicare and Medicaid Services says for these services, a beneficiary is responsible for 20% of the Medicare-approved amount along with their Part B deductible.
Coverage Added for Chronic Pain Treatment
People with chronic pain (pain lasting at least three months) can get coverage for pain control and management beginning in 2024.
Monthly services covered by Medicare include:
- Pain assessment
- Medication management
- Care planning and coordination
Beneficiaries are responsible for paying their Part B deductible and the coinsurance for these services.
Telehealth Services Available in 2024 But Dwindling in 2025
Until Dec, 31, 2024, Medicare-covered telehealth services are available. After that date, however, most telehealth appointments will be covered only if you’re in a medical facility or office in a rural location.
Some exceptions apply, including:
- Behavioral health services
- Treatment of a substance use disorder
- Diagnosis, evaluation or treatment of a mental health disorder
- Monthly end-stage renal disease visits for home dialysis
Medicare Advantage plans may provide other telehealth services, so check to see what your specific plan offers.
https://www.forbes.com/health/medicare/medicare-changes-2024/
