Medicare Part D, the prescription drug coverage program for individuals over 65 and individuals with disabilities, plays a crucial role in ensuring access to affordable medications. Each year, the program undergoes changes to adapt to the evolving healthcare landscape and address the needs of its beneficiaries. In 2024, there are several noteworthy changes in Medicare Part D that you should be aware of. Whether you are already enrolled or planning to join the program, understanding these changes can help you make informed decisions about your healthcare.
Major Medicare Part D Changes in 2024
1. Capped Out-of-Pocket Costs for Insulin
In 2023, Medicare Part D capped the out-of-pocket cost for insulin at a maximum of $35 per month across all Part D plans. In 2024, this cap will extend to include individuals in the catastrophic phase of their Part D coverage.
The catastrophic phase is the third and final phase of the Part D benefit. It begins once a person’s out-of-pocket costs reach a certain threshold, which is $7,400 in 2023. In the catastrophic phase, the Part D plan pays 95% of the cost of covered prescription drugs, and the beneficiary pays the remaining 5%.
The extension of the insulin cap to the catastrophic phase is a significant benefit for people with Medicare who use insulin. It means that they will never pay more than $35 per month for a month’s supply of insulin, regardless of their income or available resources.
2. Free Adult Vaccines
For those enrolled in Medicare Part D, certain adult vaccines, like the shingles vaccine, already come with no cost sharing. Beginning in 2024, all adult vaccines covered under Part D will be available with no cost-sharing, irrespective of a person’s income or available resources. This change ensures that Medicare beneficiaries can access all recommended adult vaccines for free, regardless of whether they have a Part D plan or not.
3. Expanded Eligibility for the Low-Income Subsidy (LIS) Program
The Low-Income Subsidy (LIS) Program offers financial assistance to Medicare beneficiaries with limited incomes and resources to help cover Part D premiums, deductibles, coinsurance, and other expenses. In 2024, an expansion of eligibility criteria will be implemented, allowing individuals with incomes up to 150% of the poverty level to qualify for full benefits, irrespective of their resources. This marks a significant expansion from the previous criteria, which only extended full benefits to individuals with incomes up to 135% of the poverty level.
What You Need to Do
To prepare for these upcoming changes in Medicare Part D for 2024, it’s essential to take the following steps:
1. Review Your Current Part D Coverage: Begin by examining your current Part D coverage and reviewing new plans that will be available in 2024. You can perform this assessment conveniently on the official Medicare.gov website.
2. Check Eligibility for the LIS Program: If you meet the income and resource criteria, consider enrolling in the Low-Income Subsidy (LIS) Program to help with Part D expenses. Detailed information and the option to apply online can be found on the Social Security Administration website.
Conclusion
The changes to Medicare Part D in 2024 are focused on reducing prescription drug costs for Medicare beneficiaries. By staying informed and reviewing your current plan, you can ensure that you’re enrolled in a plan that suits your needs. As always, be proactive in managing your healthcare options and take advantage of these changes to secure affordable and accessible prescription drug coverage under Medicare Part D. You can contact a licensed insurance agent to review your plans and make mindful changes to maximize what is available to you.