In Elder Law News

Woman pours pills from prescription bottle into her palm.If you are one of the 65 million people receiving Medicare, you may change your coverage during the annual open enrollment period. From October 15, 2023, to December 7, 2023, you can update your 2024 health and prescription drug plans. Changes you make take effect on January 1, 2024.

Medicare Part D

Most people receiving Medicare enroll in voluntary prescription drug coverage (Medicare Part D). According to the Kaiser Family Foundation (KFF), 50 million beneficiaries selected medication coverage in 2023. The open enrollment period is your opportunity to select a Part D plan for 2024.

Even if you already have prescription drug coverage, you can revisit your plan. Consider reviewing your plan yearly to understand any changes that could take effect in the following year.

Prescription Drug Plans Available For 2024

As a Medicare recipient, you have two ways to obtain Part D:

  • If enrolling in traditional Medicare, choose a stand-alone prescription drug plan (PDP); or
  • Select a single Medicare Advantage plan that covers Medicare benefits and prescription drugs. These include HMOs and PPOs.

More than 700 PDP programs are available across the United States for 2024. Plans available to you depend on your region.

Recent and Forthcoming Changes

Following the Inflation Reduction Act’s passage in 2022, Part D recipients have seen some reductions in their costs.

  • Your plan cannot charge more than $35 a month for insulin.
  • Part D enrollees can now receive many vaccines for free.
  • Come 2024, Part D beneficiaries won’t have to pay a 5 percent coinsurance for catastrophic coverage.
  • The base beneficiary premium for Part D enrollees cannot increase annually by more than 6 percent between 2024 and 2029. For 2024, it will be $34.70 (it otherwise would have risen to $39.35).
  • People struggling afford Part D premiums may qualify for assistance through the Medicare Extra Help Program’s 2024 expansion.
  • There will be an annual $2,000 cap on out-of-pocket prescription drug expenses for those with Part D, starting in 2025.
  • Lawmakers are working to negotiate lower prices on certain costly prescription medications over the coming years.

Meanwhile, from 2023 to 2024, the following costs will increase:

  • The maximum deductible is rising from $505 to $545.
  • The initial coverage limit will go from $4,660 to $5,030.
  • The out-of-pocket spending threshold is increasing from $7,400 to $8,000.

Considerations When Choosing a Plan

With so many options, it can take time to determine the right prescription drug coverage for you. Consider the following questions when selecting a program.

How much will I pay for my prescriptions?

Look for a plan that covers all the drugs you need at the lowest possible cost. The amount you’ll contribute may vary based on your specific prescriptions, how often you refill them, and what type of Part D coverage you choose.

Look at each plan to see whether it covers your prescription and how much it costs; then, compare prices across programs. (A list of these covered medications, unique to each plan, will appear in a plan’s “formulary.”)

Is traditional Medicare or Medicare Advantage appropriate for me?

Whether you decide to go with traditional Medicare and obtain a PDP, or pursue coverage through Medicare Advantage is a personal decision that depends on the type of coverage you seek. While there are more Medicare Advantage options, it is not always the best choice for everyone. A Medicare Advantage plan could be a good fit if you plan to use the additional benefits these programs may provide, such as coverage for gym memberships, groceries, and hearing, vision, and dental care.

Can I use my pharmacy?

Before selecting a plan, ensure that it includes your pharmacy in its network. Many plans, whether they’re through Medicare Part D or Medicare Advantage, have contracts with a preferred pharmacy network. Using a plan’s preferred pharmacy can save you money on out-of-pocket costs like co-pays.

Speak to an Attorney

If this is your first time getting prescription drug coverage through Medicare or you need assistance navigating the options, an elder law attorney can help you understand the coverage available to you and find a plan that suits your needs. They can also help you avoid penalties and scams.

Take time to review the 2024 Medicare & You Handbook. For additional information, call 1-800-MEDICARE or visit the Medicare website to explore your options.

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