Medicare beneficiaries need to concentrate on the changes going down in 2024 and 2025.
The changes begin with inflation adjustments for various Medicare advantages.
The base monthly premium for Medicare Part B increased $9.80 (or 5.94%) to $174.70 on January 1. The annual deductible for Part B increased $14 to $240.
The additional Part B premiums paid by higher-income beneficiaries under the Medicare Premium Additional Tax (also referred to as IRMAA) increased by about 8%. The maximum total monthly premium is $594.00. This top premium applies to individuals whose adjusted gross income was above $500,000 in 2022 and married couples whose adjusted gross income exceeded $750,000. (There is a two-year lag between when the income is raised and when it ends in higher Medicare premiums.)
Lower incomes incur lower Medicare surtaxes. The surtax begins for people with adjusted gross incomes over $103,000 and for married couples with adjusted gross incomes over $206,000.
Higher-income beneficiaries also pay a surtax on their Part D drug premiums. The maximum monthly surtax is $81.00 for a similar income level because the Part B surtax.
Another essential change concerns the utmost deductible for “catastrophe coverage” under Part D drug policies.
Congress is regularly closing the notorious coverage gap (also called the donut hole) for individuals with high prescription drug costs.
As a reminder, in 2023, a beneficiary was required to pay as much as $7,400 in prescription drug costs out of pocket before disaster coverage kicked in. After that, the beneficiary would pay 5% of all subsequent prescription drug costs within the disaster coverage area.
The 5% deductible will probably be eliminated for those covered under catastrophic coverage in 2024, and the deductible for catastrophic coverage will probably be $8,000. In 2025, the catastrophic coverage will probably be eliminated, and Medicare beneficiaries with Part D prescription plans can pay a maximum of $2,000 out of pocket for covered prescription costs.
The expansion of covered telehealth care is prolonged through at the very least the tip of 2024. The Centers for Medicare and Medicaid expanded telehealth coverage in the course of the pandemic, nevertheless it was set to run out when the pandemic’s emergency status ended. The Consolidated Appropriation Act prolonged the expanded coverage through the tip of 2024.
Unless Congress takes motion or CMM changes its policy, telemedicine will then return to the limited care rules it had in place before the pandemic.
The expanded vaccination coverage that began in 2023 will proceed.
Vaccines really helpful by the Advisory Committee on Immunization Practices to your age group are covered with no copayment, whether you’re covered by Part B or Part D. Other vaccines could also be covered if the committee recommends them to your case.
For a 30-day supply of insulin, the utmost out-of-pocket cost is $35. The $35 cap applies even when you’ve not yet met a deductible under your plan.
However, the cap only applies if the variety of insulin you’re taking is on the list of medicine covered by your plan, called the drug list. Also, the $35 cap doesn’t apply to diabetes medications that either don’t contain insulin or mix insulin with other ingredients.
Another change concerns the date on which coverage begins for individuals who enroll or make changes in the course of the annual general enrollment period.
Most people enroll in Medicare in the course of the initial enrollment period, which will likely be the seven months between the three months before and the three months after their sixty fifth birthday, after which make any changes to their coverage in the course of the annual open enrollment period, which runs from October 15 to December 7.
Less well-known is the annual general enrollment period from January 1 to March 31. This enrollment period is for individuals who missed their first enrollment period or who’re enrolled but want to make one among several changes allowed in the course of the general enrollment period.
In the past, filings or amendments made in the course of the annual general filing period didn’t take effect until July 1. Under the principles that took effect in 2023, amendments made in the course of the general filing period will take effect on the primary day of the month following the month through which the filing or amendment is accomplished.
