Benefits include increased coverage for the treatment of certain conditions, the extension of Extra Help services and the elimination of catastrophic co-payments. Other changes include additional enrollment periods and minor changes in premiums and deductibles.
Here's a summary of the main differences You can find more details in the 2024 Medicare and You Handbook.
When your out-of-pocket medicine expenses exceed a certain amount, you enter what's known as catastrophic coverage. Previously, you were required to make a co-payment of 5% for the cost of medicines once your expenses exceeded this threshold. The catastrophic coverage co-payment is eliminated as of January 1, 2024. Catastrophic coverage starts when your expenses reach $8,000.
The Extra Help program assists with Medicare Part D drug costs. Recipients of this benefit will only pay $4.50 for generic drugs and $11.20 for brand-name drugs. According to Social Security, this Extra Help assistance is worth approximately $5,300 per year.
The eligible income limits for Extra Help benefits have been increased from 135% of the Federal Poverty Level (FPL) to 150%. To qualify, your 2024 income must not exceed $21,870 ($29,580 for a married couple) and your resources must not exceed $16,660 ($33,240 for married couples). Note that eligible income excludes supplementary nutrition assistance, housing assistance and assistance from others. Eligible resources exclude your primary residence, vehicles, personal possessions and properties used for self-support.
Several Medicare benefits have been added, while others are increased for 2024.
Medicare has introduced a chronic care management service to help treat chronic pain. You must have two or more serious chronic conditions and have been in chronic pain for more than 3 months. The chronic care management benefit includes pain assessment, care coordination and medication management. There's a monthly fee, and a 20% deductible applies.
Lymphedema is a condition where one or more limbs swell as a result of blockages in the lymph nodes. Medicare now covers the cost of lymphedema compression bandages to reduce the swelling. There's a 20% deductible.
The coverage of mental health services under Medicare Part B has been extended to include services provided by mental health counselors and marriage and family therapists. This is in addition to existing services provided by clinical psychologists, clinical social workers, doctors and psychiatrists. The mental health care benefit includes outpatient mental health treatment provided by hospitals, qualified health centers and clinics.
The cost of a month's supply of insulin supplied under Medicare Part B and Part D is now capped at $35. You don't have any deductibles, but you'll still have to pay for related insulin supplies like syringes, gauze and swabs.
Medicare Part D drug plans now include coverage for all recommended adult vaccinations, including tetanus, shingles and diphtheria. These vaccinations, together with flu shots for seniors 65 and older, are covered at no cost. Medicare continues to provide coverage for the COVID-19 vaccines.
Home telehealth coverage is still available in 2024. This benefit allows virtual consultations from the comfort of your home without requiring a physical visit to your doctor.
Every year, the Centers for Medicare & Medicaid Services reviews premiums and deductibles for Original Medicare in accordance with the Social Security Act. For Medicare Part B, the standard monthly premium will increase in 2024 by $9.80 to $174.70, while the annual deductible goes up by $14 to $240. The Medicare Part A inpatient hospital deductibles go up by $32 to $1,632. The monthly income-related Part D premium adjustment that's added to your Part D plan premium has also been adjusted.
Starting in 2024, seniors will have additional options for joining a Medicare Part D plan or taking out a Medicare Advantage plan. Previously, you could only enroll in Part D during the Fall Open Enrollment period between October 15 and December 7.
In 2024, if you have to pay for your Part A premium and you sign up for Part B during the General Enrollment Period (January 1 to March 31), you'll have two months to join a Part D drug plan. Your coverage will start the month after you apply to join.
Another change applies to seniors who sign up for Part A or B during a Special Enrollment Period. In this instance, you have 2 months to either join a Medicare Part D drug plan or apply for a Medicare Advantage plan.
If you haven't already enrolled, you can get started with Medicare during the General Enrollment Period or in the 7-month period starting 3 months before your 65th birthday. Also, you can enroll for Part D when you first enroll, during Open Enrollment or a Special Enrollment Period.
To learn how you can benefit from these Medicare changes, speak to one of our caring wellness counselors at Collinwood assisted living.
