Medicare Changes in 2024

Medicare is a federal health insurance program that provides essential health care coverage to millions of Americans. Established in 1965, Medicare has become a crucial safety net for those who need it most, ensuring access to quality medical services and treatments.

This government-run program is designed to help people manage the rising healthcare costs, offering a range of benefits and services to support their well-being.

The Inflation Reduction Act (passed in 2022) included several changes to Medicare that directly impact its beneficiaries. Many of these changes affect premiums, deductibles, and out-of-pocket costs. In some cases, eligibility has been expanded to help more people afford quality healthcare. Because it primarily impacts those age 65 or older, it’s important for those who’ve reached retirement age to stay informed on any changes to Medicare.

So, whether you’re aging in place or spending your retirement traveling the country, let’s examine the changes Medicare beneficiaries can expect to see in 2024 so they can make informed decisions about their healthcare coverage.

Who is eligible for Medicare?

Medicare is available to several groups of people who meet specific criteria. The most common beneficiaries are those aged 65 or older, regardless of their income or health status. As such, it’s become a crucial aspect of planning for healthcare in retirement. However, younger individuals with certain disabilities or conditions, such as End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), may also qualify for Medicare coverage.

Some people under 65 who receive Social Security Disability Insurance (SSDI) for at least 24 months become eligible for Medicare. It’s essential for those who fall into these categories to understand their eligibility and the steps they need to take to enroll in Medicare, ensuring they have access to the healthcare coverage they need.

How Does Medicare Work?

Medicare is designed to be a user-friendly system that helps beneficiaries access the healthcare they need. To start receiving Medicare benefits, eligible individuals must enroll during designated enrollment periods. Once enrolled, beneficiaries can choose between Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C), depending on their preferences and healthcare needs.

When receiving health care services, Medicare beneficiaries typically pay a portion of the costs through deductibles, copayments, or coinsurance. Medicare covers the remaining costs, ensuring that beneficiaries have access to affordable healthcare.

Medicare is divided into four main parts, each covering specific aspects of health care:

• Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
• Part B (Medical Insurance): Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
• Part C (Medicare Advantage Plans): Offered by private companies approved by Medicare, these plans include both Part A and Part B coverage and often provide additional benefits such as prescription drug coverage.
• Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs and is run by private insurance companies approved by Medicare.

Medicare Part A and B Changes in 2024

The Inflation Reduction Act, signed into law by President Joe Biden in 2022, has introduced several changes to Medicare Part A and B that will take effect in 2024. These changes are designed to make health care more affordable and accessible for Medicare beneficiaries.

The changes that the Inflation Reduction Act makes to Medicare Parts A and B are:

Part A Premium and Deductible Adjustments

In 2024, most Medicare beneficiaries will continue to receive premium-free Part A coverage. However, for those who need to purchase Part A, the premium will decrease slightly from $506 in 2023 to $505 in 2024. The Part A deductible, which beneficiaries pay when admitted to the hospital, will increase from $1,600 in 2023 to $1,632 in 2024.

Part B Premium Increase and Income-Related Monthly Adjustment Amount (IRMAA)

Medicare Part B premiums will increase in 2024, with the standard monthly premium rising from $164.90 in 2023 to $174.70 in 2024. Beneficiaries with higher incomes may be subject to an Income-Related Monthly Adjustment Amount (IRMAA).

In 2024, the income thresholds for IRMAA will increase, with individuals earning more than $103,000 and married couples earning more than $206,000 being required to pay higher premiums.

Impact on Beneficiaries’ Out-of-Pocket Costs

The changes to Medicare Part A and B in 2024 will impact beneficiaries’ out-of-pocket costs. While most beneficiaries will not face a Part A premium increase, the higher deductible may increase out-of-pocket expenses when receiving hospital care. The increase in Part B premiums and the potential for higher IRMAA costs may also lead to greater out-of-pocket spending for beneficiaries.

However, it is important to note that the Inflation Reduction Act has also introduced several measures to help reduce Medicare beneficiaries’ out-of-pocket costs. These include provisions to lower prescription drug prices and cap out-of-pocket spending on medications.

Medicare Part D Changes in 2024

Part D refers to Medicare prescription drug coverage. In 2024, Part D will undergo several changes to make medications more affordable and accessible for beneficiaries.

For one, the average monthly premium for Medicare Part D drug plans will decrease slightly to $55.50, down from $56.49 in 2023. The 5% coinsurance for Part D’s catastrophic coverage will also be eliminated.

As with Part B, some Medicare beneficiaries with higher incomes may be subject to IRMAA for their Part D coverage. In 2024, beneficiaries with incomes above certain thresholds will pay an additional $12.90 to $81 per month, depending on their income level.

Expanded Coverage for Adult Vaccines

Thanks to provisions in the Inflation Reduction Act, Medicare Part D will offer expanded coverage for adult vaccines starting in 2024. This change will make it easier for beneficiaries to access important vaccines, such as those for shingles and pneumonia, without high out-of-pocket costs.

Medicare Advantage Plans in 2024

Medicare Advantage (MA) plans, also known as Part C, are an alternative to Original Medicare that offer combined coverage for Part A, Part B, and often Part D benefits.

The popularity of Medicare Advantage plans continues to grow, with more than 50% of Medicare beneficiaries expected to be enrolled in an MA plan in 2024. This growth can be attributed to the comprehensive coverage, additional benefits, and cost-saving potential that MA plans offer compared to Original Medicare.

Some of the changes coming to Medicare Advantage Plans in 2024 include:

New Requirements

In 2024, Medicare Advantage plans will face new requirements to help improve the quality and consistency of care for beneficiaries. These requirements include providing behavioral health coverage and ensuring that beneficiaries have access to mental health and substance abuse services.

The Centers for Medicare & Medicaid Services (CMS) will implement a standard commission for brokers and agents selling MA plans to promote fair and unbiased plan recommendations.

Midyear Notifications for Extra Benefits

Medicare Advantage plans often provide extra benefits not covered by Original Medicare, such as dental, vision, and hearing services. Starting in 2024, MA plans will be required to notify beneficiaries midyear about the extra benefits they are entitled to use. This change aims to ensure that beneficiaries are aware of and can take full advantage of the additional coverage provided by their MA plan.

Coverage for Durable Medical Equipment in MA Plans

There is no change here, but there will be a welcome continuation of coverage for durable medical equipment (DME) in 2024, including items like wheelchairs, walkers, and oxygen equipment. Beneficiaries should review their MA plan’s coverage for DME to understand any potential out-of-pocket costs or requirements for prior authorization.

Efforts to Improve Care Coordination

In 2024, the Centers for Medicare & Medicaid Services will continue to prioritize efforts to improve care coordination for Medicare beneficiaries. These initiatives aim to streamline healthcare delivery, reduce costs, and improve patient outcomes.

Care Coordination Enrollment

CMS has set a goal to enroll all Medicare beneficiaries in care coordination organizations, such as Accountable Care Organizations (ACOs), by 2030. These organizations focus on providing high-quality, coordinated care while reducing unnecessary spending. In 2024, CMS will continue encouraging beneficiary participation in these programs to improve overall health outcomes.

Reimbursement for Providers

Starting in 2024, Medicare will reimburse providers for helping patients navigate the complexities of the healthcare system. This includes assisting beneficiaries with understanding their diagnoses, treatment options, and follow-up care. By incentivizing providers to offer this support, CMS aims to improve patient engagement and adherence to treatment plans, ultimately leading to better health outcomes.

Medicare Payments for Training Family Caregivers

Recognizing the critical role that family caregivers play in patient care, Medicare will begin paying providers to train family caregivers in 2024. This initiative will help family members gain the skills and knowledge to effectively support their loved ones, particularly those with complex or chronic conditions. By investing in caregiver education, CMS seeks to improve the quality of care provided at home and reduce the burden on the health care system.

Impact of the Inflation Reduction

The Inflation Reduction Act includes provisions that support care coordination efforts. For example, the Act provides funding for expanding community health teams, which work with primary care providers to coordinate care for patients with chronic conditions. The Act also includes measures to improve the integration of behavioral health services into primary care settings, promoting a more holistic approach to patient care.

Assistance Programs and Resources

Medicare offers various assistance programs and resources to help beneficiaries navigate the complexities of the healthcare system and make informed decisions about their coverage. In 2024, these programs will continue to play a vital role in ensuring that Medicare remains accessible and affordable for all beneficiaries.

Expanded Eligibility for the Extra Help Program

The Extra Help program, also known as the Low-Income Subsidy (LIS), assists Medicare beneficiaries with limited income and resources in paying for their prescription drug costs. In 2024, the Extra Help partial program is eliminated. This means the eligibility criteria for the Extra Help program will be expanded, allowing more beneficiaries to qualify for assistance, including those with incomes up to 150% of the federal poverty level. The income and resource limits will be increased, making it easier for low-income beneficiaries to access the support they need to afford their medications.

Resources for Making Informed Decisions

As Medicare undergoes changes in 2024, it is crucial for beneficiaries to have access to reliable resources that can help them understand these changes and make informed decisions about their coverage.

CMS will continue to provide a range of resources, including online tools, helplines, and educational materials, to support beneficiaries in navigating the Medicare system. Organizations such as the State Health Insurance Assistance Programs (SHIPs) and the Medicare Rights Center will offer personalized assistance and guidance to help beneficiaries make the most of their Medicare benefits.

Preparing for the 2024 Medicare Changes

As Medicare changes in 2024, beneficiaries must take proactive steps to ensure they are prepared for these updates. By staying informed and taking action, beneficiaries can make the most of their Medicare coverage and maintain access to the healthcare services they need.

Steps Beneficiaries Can Take to Prepare

To prepare for the 2024 Medicare changes, beneficiaries should:

1. Review their current coverage and assess whether it will continue to meet their needs in light of the upcoming changes.
2. Stay informed about the specific changes that will impact their coverage, such as adjustments to premiums, deductibles, and cost-sharing requirements.
3. Evaluate their health care needs and budget to determine whether they may qualify for assistance programs like the Extra Help program.
4. Gather resources and seek guidance from trusted organizations to help them navigate the changes and make informed decisions.

Reviewing and Comparing Plan Options

Much like how it’s important to perform regular 401(k) reviews, one of the most important steps beneficiaries can take to prepare for the 2024 Medicare changes is taking the time to actively review and compare their plan options during the Open Enrollment Period. This annual event, which typically runs from October 15 to December 7, allows beneficiaries to make changes to their Medicare coverage for the upcoming year.

During Open Enrollment, beneficiaries should:

1. Carefully review their current plan’s Annual Notice of Change (ANOC) to understand how their coverage and costs may be changing in 2024.
2. Compare their current plan to other options, including Original Medicare, Medicare Advantage, and Part D prescription drug plans.
3. Evaluate each plan’s costs, benefits, and network of providers to determine which option best meets their health care needs and budget.
4. Seek assistance from trusted resources, such as the Medicare Plan Finder or SHIP counselors, to help them compare plans and make an informed decision.