It's important to stay up to date with all crucial Medicare changes! Changes to Medicare can literally affect your overall health and what type of healthcare treatment you can receive, so the better informed you are, the better you can be prepared. Look below, to discover the most current and pertinent Medicare info for your area.
Medicare Modifications: What You Need to Know
This year, several significant changes are anticipated—not only concerning deductibles, coverage choices, and premiums but also in relation to the Inflation Reduction Act. Below, we'll discuss some of the major Medicare modifications due to be implemented in 2024.
Limit on Insulin Cost Sharing
The newly ratified Inflation Reduction Act is a considerable victory for Medicare patients struggling with the cost of insulin necessary for their diabetes management. The legislation places a cap on the monthly insulin copay for Medicare Part D recipients at $35, effective from 2024.
IRA prohibits Medicare beneficiaries from exceeding a $35 per month cost-sharing for insulin supplies, deductible excluded. While plans are not mandated to cover all insulin products, all Medicare Part D plans, incorporating stand-alone drug plans and Medicare Advantage drug plans, must not charge over $35 for any insulin products within their coverage.
With Medicare now possessing the ability to negotiate lower prices for certain prescription drugs, elderly beneficiaries under Medicare will also have a $2,000 out-of-pocket cap on Part D prescription drugs annually starting in 2025.
COVID-19 Coverage
As the COVID-19 pandemic transitions into a new phase, it provides the U.S with an opportunity to employ the pandemic as a learning curve for enhancing everyone's health and standard of living. Even post-enactment of the Affordable Care Act (ACA) in 2010, vaccine coverage in Medicare programs remains uncertain.
However, these ambiguities will now be addressed thanks to the Inflation Reduction Act and the official U.S. government Medicare handbook. Here are the covered preventive services for COVID-19:
Vaccines: All booster shots and additional doses are free of charge.
Diagnostic tests: If mandated by a healthcare provider, you can undergo testing free of charge at their designated laboratory, pharmacy, doctor, or hospital.
Antibody tests: No charges apply to these tests while COVID-19 remains a public health emergency.
You can also access Monoclonal Antibody Treatment and over-the-counter (OTC) tests free of charge.
Coverage for Kidney Transplants and Immunosuppressive Drugs
The upcoming changes also affect the coverage of immunosuppressive medications for certain kidney transplant recipients. Medicare coverage for beneficiaries who applied for Medicare due to their End Stage Renal Disease (ESRD), including immunosuppressive drugs, will automatically expire 36 months after a successful kidney transplant.
But rest assured, Medicare is poised to introduce a new benefit that assists with immunosuppressive drug expenses even post 36 months, given you lack other health coverage.
This new benefit is not a substitute for comprehensive health coverage and solely covers your immunosuppressive drugs and excludes other items or services.
Changes in Start Dates for Medical Coverage
New enrollees in Medicare should expect alterations in the start dates for medical coverage. American citizens turning 65 won't have to wait as long for their benefits to kick in, which is fantastic news!
Starting January 1, 2024, seniors who sign up for Medicare during:
The month they turn 65;
The last three months of the initial enrollment period; and
The general enrollment period.
Will be eligible for Medicare coverage on the first day of the month following their enrollment.
Special Enrollment Period for Medicare
Missed your enrollment period due to unforeseen events? There's no cause for concern. Starting 2024, Medicare is implementing a Special Enrollment Period with a few exceptions.
You may qualify for the Special Enrollment Period if you are affected by these unfortunate events:
Emergency
Incarceration
Natural disaster
Loss of Medicare coverage
There won't be any penalty fee if you register during the Special Enrollment Period. However, this doesn't apply if you're still within the initial enrollment period or if you already have Medicare for your End-Stage Renal Disease (ESRD).
Open Enrollment Period
Despite the provision of a Special Enrollment Period, it's advisable to adhere to the designated schedule to avoid enrollment issues with Medicare. You can join, switch, or completely drop your Medicare Advantage Plan or a Medicare drug plan from October 15 to December 7, 2023.
Those interested should take note of these important dates as this might be your sole chance each year to modify your coverage.
By the beginning of 2024, beneficiaries will start experiencing the aforementioned changes in their plans.
Learn More About Medicare Changes
These alterations pave the way for new opportunities for those currently enrolled in Medicare or future enrollees. It's important to review your Medicare health and drug coverage. Determine if your plan still meets your needs and assess if there's a need for a new one. Get to grips with these forthcoming changes so you can utilize them to your advantage. Maximize your coverage today!