If you’re on Medicare, or you’re simply aware of the program, it probably comes as no surprise to you that plan changes are on the horizon. Even if they’re minor, changes are made to Medicare plans each year. 2024 will be no different.
Medicare plan changes coming in 2024 are largely a result of the 2022 passage of the Inflation Reduction Act (IRA). The post-pandemic law focuses on the affordability of prescription medications for seniors, as well as increasing access to needed medications for most. In all, six major Medicare reforms will become effective next year thanks to the IRA.
To help you make better sense of the topic, we reached out to our friends at MedicareInsurance.com to elaborate on some of the key Medicare changes coming in 2024. Even if you haven’t enrolled and are simply considering a Medicare plan, it’s still important to give this a read. These reforms will have a profound effect on any plan you choose in the coming year. They may also help you keep your budget in a positive place!
Medicare Part B & Medicare Advantage: New Cost-Sharing Limits for Insulin Delivered via Pump
Currently, Medicare Part B helps you pay the cost for your insulin if you use a traditional insulin pump*. In the past, you may have had to pay more out of pocket than you’d like for that insulin. As of July 1 of this year, that has changed.
If you have Medicare Advantage or Medicare Part B, cost-sharing is now limited to no more than $35 per month for insulin delivered via a traditional insulin pump. You will still need to cover 20 percent of costs after reaching your Part B deductible. You will also still be required to pay 100 percent for all insulin-related supplies, unless you’re enrolled in a Part D Prescription Drug plan.
*If you have Medicare Part B, it will not cover: insulin pens, syringes, needles, alcohol swabs, or gauze.
Medicare Part D: Cost-Sharing, Catastrophic Coverage Coinsurance Elimination, and Annual Prescription Drug Cost Limits
Those of you who use your Part D plans to help cover insulin, these cost-sharing limits extend to you as well. Medicare Part D plans can no longer charge more than $35 per month for covered insulin products.
Another major change coming for Part D plans in 2024 involves the elimination of 5 percent coinsurance for catastrophic coverage. If you’ve ever had to spend more than $3,000 on medication while being enrolled in a Part D plan, you know about the catastrophic phase of your Part D benefit. In this phase, you were responsible for covering 5 percent of your prescription drug costs Out-of-Pocket (OOP) for the rest of the year. Whether you’re renewing your Part D plan or enrolling in a new one for the coming year, you will no longer be responsible for that 5 percent coinsurance should you ever enter the catastrophic phase of coverage.
Starting in 2025, Medicare will place a strict cap on how much you’ll spend for prescription medications. The annual limit will start at $2,000, meaning you’ll never spend more than $2,000 per year for prescription drugs covered by your Part D plan. After 2025, this cap will be adjusted according to inflation rates.
Coverage of Vaccines
At one point, Medicare Part D and Medicare Advantage plans may have required deductibles or coinsurance for vaccines. That changed as of January 1, 2023. Going forward, your Medicare Part D and/or Medicare Advantage plan will no longer require you to share the cost of your vaccine.
These New Provisions Seek to Help Lower Costs for Medicare Beneficiaries Going Forward
One major complaint you’ve probably heard about Medicare plans is that, even though they seek to help reduce your costs, they aren’t much help in a time when costs are higher than ever. If you’re a senior living on a low fixed income, every single dollar and cent counts.
Thanks to the passage of the Inflation Reduction Act, healthcare and prescription drug costs are set to become more manageable for those of you on fixed incomes. In time, other positive changes to Medicare may come as well.