Nothing in life is constant, and that includes Medicare coverage. The government health insurance program for seniors and individuals with a qualifying disability typically makes adjustments each year, and 2024 is no exception.
After Jan. 1, Medicare recipients will have different monthly premiums as well as expanded financial aid and coverage options.
Here’s a look at what’s changing for Medicare in 2024.
1. Higher premiums and deductibles
Brace yourself: Almost all Medicare costs will be increasing in 2024. These include the following premiums and deductibles:
- Medicare Part A inpatient deductible: $1,632 for the first 60 days of a hospitalization in a benefit period, up from $1,600 in 2023
- Medicare Part B standard premium: $174.70 per month, up from $164.90 in 2023
- Medicare Part B deductible: $240 per year, up from $226 in 2023
Plus, income-adjusted premiums for high earners and co-insurance costs are rising. You can see all the details in this Money Talks News article.
2. A higher Part D coverage gap threshold
You may have heard about the so-called “doughnut hole” in prescription drug coverage through Medicare Part D. It’s a gap in coverage that occurs after your plan has paid out a certain amount in benefits. At that point, you start paying up to 25% of your medication costs until you reach your plan’s catastrophic coverage limit.
The good news for 2024 is that the threshold for when you enter the Part D coverage gap is increasing. In 2023, you entered the gap — the doughnut hole — after your plan paid $4,660 in drug costs. But in 2024, that amount is rising to $5,030.
And in even better news, the coverage gap will be going away entirely in 2025, thanks to the Inflation Reduction Act of 2022 passed by Congress and signed by President Joe Biden.
3. A higher Part D catastrophic coverage threshold
In 2024, you’ll hit catastrophic coverage once your out-of-pocket spending reaches $8,000. That’s up from $7,400 in 2023.
4. No more Part D catastrophic coinsurance
Once you reach the catastrophic coverage level of your Part D plan, in 2024, you won’t have to pay a dime more. That’s an improvement over 2023, when you could still be required to pay up to 5% coinsurance after reaching the catastrophic level of coverage.
5. A cap on Part D premium increases
Another provision of the Inflation Reduction Act caps how much Part D base premiums can increase each year. For 2024 through 2029, rate hikes are limited to 6% annually.
6. Expanded Extra Help financial aid
Those with limited income and resources may be eligible for financial aid to help cover their Medicare drug costs. Known as Extra Help, this program automatically enrolls anyone who is also receiving Medicaid, Supplemental Security Income (SSI) or state assistance for Medicare costs. Other people can apply for the program online.
It used to be that some people could qualify for partial Extra Help, but starting in 2024, everyone who qualifies partially will be given the full program benefits. Those who are enrolled will pay no more than $4.50 to fill prescriptions for generic drugs and $11.20 for brand-name medications.
7. Coverage of chronic pain management
If you’ve been living with chronic pain, you may find some relief thanks to this change in Medicare coverage: Starting in 2024, plans will begin covering services such as pain assessments, medication management and care coordination for those who have had persistent or recurring pain for at least three months.
The Part B deductible and coinsurance apply, though.
8. Coverage of lymphedema compression garments
In 2024, Medicare will begin paying for gradient compression garments for those diagnosed with lymphedema, which is a build-up of fluids in the legs, arms or elsewhere in the body associated with the lymphatic system.
Both standard and custom-fitted garments are covered, but you’ll have to pay 20% of the Medicare-approved amount, and the Part B deductible applies.
9. Coverage of marriage and family therapist services
The Mental Health Access Improvement Act of 2022 added marriage and family therapists to the list of practitioners eligible to receive Medicare Part B payments. That means people on Medicare can now receive marriage and family therapy and have it covered the same as any other approved outpatient service.
To learn more about this change, check out “2 Ways a New Law Expands Medicare Coverage.”
10. Coverage of mental health counselor services
The same law that added marriage and family therapists to the list of Medicare-approved practitioners also added mental health counselors to that list. As a result, they can now bill Medicare Part B for their services.
11. Coverage of intensive psychiatric outpatient programs
Medicare’s expanded mental health coverage goes beyond counseling sessions. In 2024, Medicare plans will begin covering intensive outpatient mental health programs, which offer more rigorous care than is provided in a therapist’s office. These programs, also known as partial hospitalizations, include those offered by hospitals, community mental health centers, federally qualified health centers and Rural Health Clinics.
Patients will pay a percentage of the Medicare-approved amount, however, and the Part B deductible and then coinsurance apply.
12. More time to sign up for Part D (for some people)
If you are one of the very few people who has to pay Medicare Part A premiums, you’re getting extra time to sign up for a Part D drug plan. Starting in 2024, those who pay for Part A and sign up for Part B during the general enrollment period (which always runs from Jan. 1 to March 31) will have two months from the time they sign up for Part B to then sign up for a Part D drug plan.