Another year means more changes coming to Medicare. In this article, we'll outline all of the major Medicare changes coming in 2024.
From increased Medicare Part B costs to expensive drug negotiations coming as a result of the Inflation Reduction Act (IRA), here's what you and your clients should know about Medicare in 2024.
2024 Medicare Costs
As always, Medicare costs are changing in 2024. Unlike last year, costs are increasing.
Part B Premium & Deductible Increases
In 2024, the standard Medicare Part B premium is $174.70, an increase of nearly $10 compared to 2023.
The Part B deductible is also going up to $240 in 2024, a $14 increase from 2023.
Note: to easily show these costs to your clients, you can download a 2024 Medicare Costs fact sheet from CMS, or you can take advantage of our customizable 2024 Medicare Costs handout:
Part B IRMAA
For about 7 percent of people with Medicare Part B that have a high income, their Part B premiums will range from $244.60-$594 per month.
Part A Costs
Here are some quick Part A cost highlights for 2024:
- 2024 Part A premium: up to $505 per month
- 2024 Part A deductible: $1,632 ($1,600 in 2023)
- 2024 Part A coinsurance for Days 1-60: $0
- 2024 Part A coinsurance for Days 61-90: $408 per day ($400 in 2023)
- 2024 Part A coinsurance for lifetime reserve days: $816 per day ($800 in 2023)
- Skilled nursing facility daily coinsurance for days 21-100: $204 ($200 in 2023)
Most people don't pay a monthly premium for Part A. For those that paid Medicare taxes for less than 30 quarters, the standard Part A premium is $505 in 2024 (a $1 decrease from 2023). And for those that paid Medicare taxes for 30-39 quarters, the standard Part A premium is $278 in 2023 (the same as 2023).
Help your clients understand their 2024 Medicare costs with customizable and fillable Client Guide to Medicare Parts A & B.
Medicare Technology
Integrity has made serious investments in technology to help you produce more and serve your clients more efficiently.
We're so excited about the recent developments with MedicareCENTER and LeadCENTER, and we're excited to continue sharing new features and updates in 2024.
LeadCENTER has had a ton of recent improvements. Check out the latest announcements:
Inflation Reduction Act (IRA) Changes
Big changes are still coming to Medicare Part D as a result of the Inflation Reduction Act (IRA), which was signed into law in August 2022.
These changes are being slowly rolled out each year, starting on January 1, 2023 and going all the way through 2029 and beyond.
No-Cost Vaccines & $35 Insulin Copay Cap
The $35 per month price cap for insulin that was in effect during 2023 is extending through 2024.
Starting in 2024, all recommended adult vaccines that are covered by Medicare will now be available with no cost-sharing.
Drug Negotiations
The government announced on Tuesday, August 29, 2023 the first 10 prescription drugs that will be subject to price negotiations:
- Eliquis
- Jardiance
- Xarelto
- Januvia
- Farxiga
- Entesto
- Enbrel
- Imbruvica
- Stelara
- Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill
In 2024, we can expect CMS to make an initial offer for the maximum fair price, along with a detailed explanation, by February 1. Companies then have 30 days to respond, choosing to accept the offer or propose a counteroffer.
If CMS and the drug company can't agree, they will do up to three more negotiation meetings in Spring and Summer 2024. All negotiations will wrap up by August 1, 2024.
If all goes well, your clients should experience much lower out-of-pocket costs if they have prescriptions for any of these 10 drugs.
The maximum fair prices for these first 10 drugs will go into effect in 2026. But it doesn't stop here – by February 1, 2025, CMS will announce 15 more Medicare Part D drugs for negotiation.
2024 Medicare Advantage Changes
Another year, another mention of big growth for Medicare Advantage. 2024 is slated to be the biggest year yet for Medicare Advantage enrollments.
Source: KFF
In 2024, the average Medicare beneficiary chose from 43 Medicare Advantage plans, the same number of plans as last year.
With 66% of MA-PDs charging $0 premium (other than the Part B premium) and great access to quality plans with nationwide networks, it's easy to see why MA is growing so rapidly.
Source: KFF's Medicare Advantage 2024 Spotlight
If you aren't yet selling MA plans, we highly encourage you to reach out to us for help getting started!
2024 PDP Cost Changes
According to KFF, "The estimated average enrollment-weighted monthly premium for Medicare Part D stand-alone drug plans is projected to be $48 in 2024, based on current enrollment, up 21% from $40 in 2023."
This increase is due to the expected higher plan costs – it's simply getting more expensive to cover prescription drug costs. Hopefully, the drug negotiations going on right now will lower costs as we go into the future.
In addition, starting January 1, 2024, if your client has Medicare drug coverage (Part D) and their drug costs are high enough to reach the catastrophic coverage phase, they don’t have to pay a copayment or coinsurance.
Medicare Enrollment Period Changes
New for 2024 is if your client recently lost (or will soon lose) Medicaid, they may be able to sign up for Medicare or change their current Medicare coverage. You can read more about that in the 2024 Medicare & You Handbook.
Medicare Benefit Changes
For 2024, there are a few benefit changes.
- Telehealth: your clients can still get telehealth services at any location in the U.S., including their home, until the end of 2024. After that, they must be in an office or medical facility located in a rural area to get most telehealth services. There are some exceptions, like for mental health services.
- Chronic pain: Medicare now covers monthly services to treat chronic pain if the individual has been living with it for more than 3 months.
- Mental health: starting January 1, 2024, Medicare will cover intensive outpatient program services provided by hospitals, community mental health centers, and other locations if you need mental health care.
Conclusion
Medicare continues to evolve, and it's important that we stay on top of those updates so we can educate our clients.
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