A new year means changes to Medicare, including updates to drug coverage, telehealth services and mental well-being considerations. In 2024, we don’t see as many changes as there were for 2023, but there are some notable tweaks that will make you want to reassess whether your plan still fits your needs so you get the most from your Medicare benefits. Here are some key 2024 updates, according to the Centers for Medicare & Medicaid Services.
Here are the key changes Medicare beneficiaries and Medicare enrollees should expect in 2024 when it comes to Medicare coverage.
Medicare Part D Prescription Coverage
- Once your out-of-pocket spending reaches $8,000 (including certain payments made by other people or entities, including Medicare’s Extra Help program, on your behalf) you won’t have to pay a copayment or coinsurance for covered part D drugs for the rest of the calendar year.
- Extra Help—a program that helps cover your Part D drug costs—will expand to cover more drug costs for certain people with limited resources and income.
- Coinsurance amounts for some Part B-covered drugs may be less if a prescription drug’s price increased higher than the rate of inflation.
- Your Medicare drug plan can’t charge you more than $35 for a one-month supply of each insulin product Part D covers, and you don’t have to pay a deductible for it.
- If you take insulin through a traditional pump that’s covered under Medicare’s durable medical equipment benefit, that insulin is covered under Medicare Part B. You won’t pay more than $35 for a month’s supply and the Medicare deductible no longer applies.
- Recommended adult vaccines are also now available at no cost to you.
- Drug costs for people who qualify will generally be no more than $4.50 for each generic drug and $11.20 for each brand-name drug
Telehealth Services
You can still get telehealth services at any location in the U.S., including your home, until the end of 2024. After that, you must be in an office or medical facility located in a rural area to get most telehealth services. There are some exceptions, like mental health services.
Chronic Pain Management
Medicare now covers monthly services to treat chronic pain if you’ve been living with it for more than 3 months.
Mental Well-Being
- Medicare will cover intensive outpatient program services provided by hospitals, community mental health centers, and other locations if you need mental health care.
- Medicare will also cover mental health care services provided by marriage & family therapists and mental health counselors.
More Chances to Enroll
- If you recently lost (or will soon lose) Medicaid, you may be able to sign up for Medicare or change your current Medicare coverage. There are other special situations that allow you to sign up for Medicare.
- If you sign up for Part A or Part B during a Special Enrollment Period because of an exceptional condition (go to page 18), you’ll have 2 months to join a Medicare Advantage Plan (with or without drug coverage) or a Medicare drug plan (Part D). Your coverage will start the first day of the month after the Medicare Advantage Plan gets your request to join.
- If you have to pay for Part A, and you sign up for Part B during the General Enrollment Period (January 1 – March 31), you can also join a Medicare drug plan when you sign up for Part B. You’ll have 2 months after signing up for Part B to join a drug plan. Your drug coverage will start the month after the plan gets your request to join.
>>Learn more about the Annual Enrollment Period
COVID-19 Care
Medicare continues to cover the COVID-19 vaccine and several tests and treatments to keep you and others safe.
Provider Access
Even though the network of providers may change during the year, the plan must still give you access to qualified doctors and specialists. Your plan will notify you that your provider is leaving your plan so you have time to choose a new one. You’ll get this notice if it’s a primary care or behavioral health provider and you have gone to that provider in the past three years. If any of your other providers leave your plan, you’ll get this notice in certain situations.
Lymphedema Care
If you’ve been diagnosed with lymphedema, Medicare will cover your prescribed gradient compression garments (standard and custom-fitted). You pay 20% of the Medicare-approved amount. The Part B deductible applies.
Have Medicare changes in 2024 questions? Now is a great time to ask! We’re here to support you on your journey to live a better, healthier life. Reach out to us if you need help sifting through the changes and what that can mean for your plan!
Need help looking at your options? Give Karen or Matt a call at 865-203-2040 or email us at contact@seniorinsurancespecialty.com!
*We do not offer every plan available in your area. Currently, we represent 11 organizations which offer 126 products in your area. You can contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program for help with plan choices.