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Medicare’s Open Enrollment is in Full Swing ~ Review Your Coverage Options for 2024

Medicare’s Fall Open Enrollment, officially known as the Annual Enrollment Period (AEP) is in full swing! It runs from October 15 – December 7, and is the time you can change your Medicare health plan and Part D coverage and/or return to Original Medicare. Coverage changes become effective January 1, 2024.

It’s an important time to review your coverage, and any health plan and Part D plan changes for 2024. Each year plans can change their premiums, out-of-pocket costs, drug formularies, network of covered providers and more, so it is good to see whether or not your current plan will still be a good fit for 2024. Contact your local Health Insurance Counseling and Advocacy Program (HICAP) for free counseling and information on your health care options in your area.

Note that in 2024:

  • Medicare Part D will have some more cost-saving changes due to Inflation Reduction Act of 2022 (IRA). These include:
    • Eliminating any coinsurance or co-payments during the catastrophic phase of the prescription drug benefit as of January 1.
    • Limiting Part D plan premium increases to 6% over what it was the previous year. This protection continues through 2029. The law also provides for a mechanism to stabilize plan premiums in 2030 and subsequent years.
    • Expanding the full Low-Income Subsidy (LIS) also known as Part D Extra Help to those with incomes up to 150% of the federal poverty level. This will offer expanded financial help with prescription drug cost-sharing and premiums.
  • Medicare Part D cost-saving changes from the IRA in 2023 will continue. These include:
    • Limiting insulin copayments to $35/month per prescription for covered insulin products in Medicare Part D plans and insulin received through durable medical equipment through Medicare Part B (such as insulin pumps) with no deductible.
    • Eliminating cost-sharing for adult vaccines covered under Part D (i.e. shingles), even if the deductible hasn’t been met.
    • Requiring drug companies to pay rebates if prices rise faster than inflation.
  • See the Center for Medicare and Medicaid Services’ summary timeline for all the cost-saving changes due to IRA over the next several years.
  • Medicare Advantage plans will continue to offer supplemental benefits in 2024 – With what started in 2020, MA plans can continue to offer new health and non-health related supplemental benefits in their plans. These benefits can be a bit misleading as they are not necessarily offered to all enrollees; they have specific eligibility criteria and limitations; and they could overlap with Medi-Cal benefits for dually eligible beneficiaries. Make sure to closely review plan member Handbook, as MA plans are required to clearly spell out the eligibility requirements for any supplemental benefits. See our past article for more info: Tips to Navigate Medicare Advantage Plans’ New Supplemental Benefits.
  • Look for other options. If your health plan or drug plan is terminating its coverage, you should have received a notice by October 2 informing you of your rights and options for other coverage. See When Medicare Advantage Plans Terminate Coverage.
  • Be on the alert. Medicare health plans and prescription drug plans started marketing their 2024 plans as of October 1, 2023. Agents and brokers selling these plan must follow strict guidelines when marketing to you. Review our recent article and our updated novella that shares what Medicare health plans and their agents CANNOT do in their plan marketing and provides savvy tips on how to protect yourself from enrollment fraud. It’s available in English and Spanish. Report any suspected marketing or enrollment fraud or abuse to the Senior Medicare Patrol at 1-855-613-7080.