Medicare Advantage and Medicare prescription drug programs to remain stable in 2024 - Insurance News | InsuranceNewsNet

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September 26, 2023 Health/Employee Benefits News
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Medicare Advantage and Medicare prescription drug programs to remain stable in 2024

By Press Release

The Centers for Medicare & Medicaid Services announced that average premiums, benefits, and plan choices for Medicare Advantage and the Medicare Part D prescription drug program will remain stable in 2024. Improvements adopted in the 2024 Rate Announcement, as well as the 2024 Medicare Advantage and Part D Final Rule, such as increased beneficiary protections around marketing and prior authorization and increased access to behavioral health, support this stability. 

Additionally, through the Inflation Reduction Act, people with Medicare Part D prescription drug coverage will continue to have improved and more affordable benefits, including a $35 cost-sharing limit on a month’s supply of each covered insulin product, recommended adult vaccines at no cost, and additional savings on their Medicare Part D drug coverage costs in 2024. These savings include the expansion of the Low-Income Subsidy program, also called Extra Help, which helps eligible enrollees afford their premiums and cost-sharing, as well as a cap on out-of-pocket costs for millions of people with very high drug costs in the catastrophic phase of the Part D benefit.

CMS is releasing this key information, including 2024 premiums and deductibles for Medicare Advantage and Medicare Part D prescription drug plans, ahead of the upcoming Medicare Open Enrollment, beginning Oct. 15, 2023, to help people with Medicare determine the best Medicare coverage option for their health care needs.

The average monthly plan premium for all Medicare Advantage plans, which includes Medicare Advantage-Prescription Drug plans, is projected to change from $17.86 in 2023 to $18.50 in 2024 (an increase of $0.64). If enrollees choose to stay in their plan, most will experience little or no premium increase for next year, with nearly 73% of beneficiaries not seeing any premium increase at all. Plan choice is also increasing, and people with Medicare continue to have the ability to switch Medicare options. Medicare Advantage supplemental benefit offerings will increase slightly in 2024.

Enrollment in Medicare Advantage is projected to increase from 31.6 million in 2023 to 33.8 million in 2024. The projected Medicare Advantage enrollment in 2024 will represent approximately 50% of all people enrolled in Medicare, compared to approximately 48% for 2023.

In addition, more than 1,500 Medicare Advantage plans will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design Model in 2024, which will test the effect of offering person-centered innovative benefits that are critical to meeting health care needs and improving health equity to a projected 8.7 million people. The VBID Model expands access to additional supplemental benefits that can address a wide range of needs, such as food and nutrition benefits. The VBID Model offers plans the flexibility to target these benefits to people with chronic conditions or low incomes.

The VBID Model’s Hospice Benefit Component, now in its fourth year, will also be offered by 78 Medicare Advantage plans in portions of 19 states and U.S. territories, providing enrollees increased access to palliative and integrated hospice care.

CMS previously announced that the average total monthly premium for Medicare Part D coverage is projected to be approximately $55.50 in 2024. This expected amount is a decrease of 1.8% from $56.49 in 2023.

Medicare open enrollment - important dates and resources

Medicare Open Enrollment begins on October 15, 2023, and ends on December 7, 2023. During this time, people eligible for Medicare can compare 2024 coverage options on Medicare.gov. Medicare.gov, as well as the Medicare Plan Finder, provide clear, easy-to-use information to allow people to compare options for health and drug coverage, which may change from year to year. 

Medicare Plan Finder will be updated with the 2024 Medicare health and prescription drug plan information by October 1, 2023. 1-800-MEDICARE is also available 24 hours a day, seven days a week, to provide help in English and Spanish as well as language support in over 200 additional languages. People who want to keep their current Medicare coverage do not need to re-enroll.

During Open Enrollment, people with Medicare are encouraged to call 1-800-MEDICARE or contact their State Health Insurance Assistance Programs (https://www.shiphelp.org/) for help comparing plans and costs this year.

To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs are essential to help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments if people meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other necessities like food, housing, or transportation. Individuals interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.

In addition, the Low-Income Subsidy Program, also called Extra Help, is a Medicare program that helps qualifying individuals pay Part D premiums, deductibles, coinsurance, and other costs. In 2024, this program is expanding thanks to the Inflation Reduction Act, allowing all eligible enrollees to benefit from no deductible, no premium, and fixed lower copayments for certain medications. Enrollees can save nearly $300 per year, on average, according to estimates; up to 3 million seniors and people with disabilities could benefit from the Extra Help program now but aren’t currently enrolled. Individuals who enroll in MSPs automatically qualify for help affording their prescription drugs through the Extra Help program. To learn more about the Low-Income Subsidy Program, visit: Medicare.gov/extrahelp.

To view the premiums and costs of 2024 Medicare Advantage and Part D plans, please visit: https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin. Select the various 2024 landscape source files in the downloads section of the webpage.

For state-by-state information, important dates, and enrollment resources for Medicare Advantage and Part D in 2024, please visit: https://www.cms.gov/files/document/2024-ma-part-d-landscape-state-state.pdf

For more information on the Medicare Advantage Value-Based Insurance Design Model, including plan participation, please visit: https://www.cms.gov/priorities/innovation/innovation-models/vbid.

 

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