Changes to Medicare

Changes to Medicare Advantage

• Improvements in health equity: There are three key changes for 2024 designed to improve access to healthcare and overall experience under Medicare Advantage.
  • Enhanced provider directories: Advantage plans must now update their provider directories to align with Medicaid standards. Directories will now include information about providers’ cultural and linguistic capabilities, making it easier for plan participants to find providers who can communicate effectively and understand needs.
  • Access to telehealth and behavioral health benefits: Advantage plans will also develop processes to offer digital health education to enrollees, facilitating and improving access to telehealth benefits. This means you’ll have more opportunities to receive virtual healthcare services, making it convenient and accessible, especially for those facing transportation or distance challenges.
  • Culturally competent care: New CMS guidelines expand the consideration of populations to ensure healthcare services are provided in a culturally competent manner. This means plans will be better equipped to meet the diverse needs of disabled individuals, LGBTQIA+ individuals, and those in rural areas or who are experiencing persistent poverty.

Changes to Medicare Part D (Prescription Drug Benefit)

• Coinsurance eliminated for enrollees: Beginning in 2024, the 5% coinsurance requirement for Part D enrollees in the catastrophic phase will be eliminated. Part D plans will also now pay 20% of total drug costs instead of 15%, meaning Part D enrollees without low-income subsidies (LIS) will have their out-of-pocket spending capped at $8,000. For those with high-cost medications, this change can save thousands of dollars. 
• Change in low-income subsidy eligibility: Also, for 2024, enrollees who have incomes up to 150% of the poverty line (and resources at or below the limits for partial low-income subsidy benefits) will be eligible for full benefits under the Part D (LIS) Program.
• Base beneficiary premium adjusted: The calculation of the base beneficiary premium will be adjusted to limit increases to no more than 6% from the prior year.

Changes to the Medicare Marketing Rules

There are several Medicare marketing changes, but only one is likely to directly impact consumers: Now, when someone arranges to meet with an agent, there must be a 48-hour period between making an appointment and the first meeting with the agent.

If you have any questions or need assistance understanding how these changes may affect you, please don’t hesitate to reach out. I’m here to help you navigate your Medicare coverage and ensure you receive the best possible care at the most affordable cost. Please call Scott to help you decide on what plan will work best for you in 2024.