Medicare Annual Enrollment, Part One

The 2024 edition of Medicare & You has been released by the Centers for Medicare & Medicaid Services (CMS). It signals the launch of an informational onslaught that accompanies Medicare’s annual enrollment period, which begins October 15 and extends through December 7.

If you have Medicare, you are free to change your coverage next year, generally with no penalties or adverse underwriting consequences. There are many choices, and they can be confusing:

·         People with Part D plans, whether as part of Original Medicare or bundled in with a Medicare Advantage plan, can switch to another plan.

·         People with Original Medicare can switch to an MA plan.

·         People with an MA plan can switch to another plan or leave MA and use Original Medicare. If they do so, and want a private Medigap supplement plan, they may face higher costs and even some availability challenges. Medigap plans are regulated by the states, and do not offer the kind of costless switching found with Part D and MA plans.

·         People who do nothing will have their current plans automatically renewed. Chalk up a win for couch potatoes. However, every survey I’ve seen finds that year-to-year plan changes may offer improved coverage, lower costs, or both, to people who take the time to research next year’s plan offerings.

This year’s Medicare & You handbook looks much like last year’s, which was nearly identical to the previous year’s, which was, well, you get the idea. There are lots of small annual changes to the program but not so many big changes. Helpfully, they are spelled out near the beginning of Medicare & You.

For 2024, the most important changes are related to the prescription drug provisions of the Inflation Reduction Act. They include:

·         The end of copays or coinsurance in the catastrophic phase of Part D plans. Once your spending reaches this level, you will pay nothing for prescription drugs.

·         Extra Help, which helps cover Part D drug costs for some people with lower incomes, will provide more generous benefits.

·         Coinsurance amounts for some Part B-covered drugs may decline if its price has risen at a rate higher than general price changes. Part B covers drugs administered by a professional outside the home.

·         Insulin prices will be capped at $35 a month in Part D and Part B settings.

·         Recommended vaccines will be free.

Other changes highlighted by CMS:

·         You can still get telehealth services at any location in the U.S., including your home, until the end of 2024. After that, you must be in an office or medical facility located in a rural area to get most telehealth services.

·         Medicare now covers monthly services to treat chronic pain if you’ve been living with it for more than three months.

·         Starting January 1, 2024, Medicare will cover intensive outpatient program services provided by hospitals, community mental health centers, and other locations if you need mental health care.

·         If you recently lost (or will soon lose) Medicaid, you may be able to sign up for Medicare or change your current Medicare coverage.

·         Medicare will continue to cover the COVID-19 vaccine, and several related tests and treatments.

During September, private Medicare health plans must also provide important details of 2024 plan changes. These will be contained in two documents you should receive – an Annual Notice of Change (ANOC) that provides highlights, and an Evidence of Coverage (EOC) that provides complete details on your plan’s coverage.

You can also expect to see marketing and advertising messages, particularly from MA plans. They shouldn’t be as intrusive as in past years, following the issuance last year by CMS of what amounted to “cease and desist” warnings to plans to curb abuses.

I will have more to say on annual enrollment as Oct. 15 nears.

Journalist Philip Moeller is the principal author of Simon & Schuster’s Get What’s Yours series of books about Social Security, Medicare, and health care. He is working on a new edition of his Medicare book.