Almost 66 million Americans use Medicare services annually, and while the core benefits of the program remain constant, notable cost changes are updated every year.
Created as an insurance coverage plan for those over 65, Medicare offers four levels of benefits that cover everything from hospital insurance to prescription medicine costs. If you are unfamiliar with Medicare, we put together this comprehensive guide so you can better understand the program.
Medicare Enrollment Basics
Whether you are just now becoming eligible or need to alter your ongoing coverage, the open enrollment period for Medicare runs from October 15th to December 7th every year. Typically the area in which most changes take place is Medicare Part D, which primarily deals with prescription medicine costs that “Original Medicare” (Parts A and B) does not cover.
While Medicare has helped millions over the years, navigating the constantly changing program can be intimidating. This is why Community Pharmacy provides comprehensive plan reviews via phone or in-person appointment.
In just 30 minutes we can review your current plan and ensure you have the best coverage option selected so you can continue receiving your prescriptions at an affordable rate.
2024 Medicare Part D Costs Updates
While the cost of Part D insurance premiums is expected to decrease from an average of $56.49 in 2023 to $55.50 in 2024, Medicare Part D cost limits covered are expected to rise.
Divided into four phases, here’s a complete breakdown of Part D cost limit changes for 2024:
- Phase 1: Deductible
- Patients pay full price for in-network prescriptions until the deductible amount is reached.
- In 2023, the annual deductible limit was set at $505.
- In 2024, the annual deductible limit will increase to $545.
- Phase 2: Initial Coverage
- Patients pay a fixed amount of copay or percentage of the negotiated cost of a prescription until they reach the initial coverage limit.
- In 2023, the initial coverage limit was $4,660.
- In 2024, the initial coverage limit will increase to $5,030.
- Phase 3: Coverage Gap (aka Donut Hole)
- Generally, patients pay 25% of the retail costs of their prescription medications until the coverage gap limit is reached.
- In 2023, the coverage gap limit was $7,400.
- In 2024, the coverage gap limit will increase to $8,000.
- Phase 4: Out-of-Pocket (aka Catastrophic Phase)
- At this phase, patients pay a small coinsurance percentage or copay dollar amount on eligible drugs
- In 2023, this translated to $4.15 for generic medications, and $10.35 for brand-name, or 5% of the total cost (defaulting to the highest amount of the three).
- In 2024, these limits will increase to $4.50 for generic medications and $11.20 for brand names.
Another notable change to take place in 2024 includes the expansion of the “Extra Help” program. Those with limited income and resources can qualify to receive lower copayments and other benefits.
How Community Pharmacy Can Help
Whether you are a patient yourself or a caregiver for a loved one on Medicare, what you need most throughout the enrollment process is clarity regarding your best coverage option.
By scheduling a personalized plan review appointment with an experienced pharmacist familiar with the Medicare system, you can feel confident about finding an affordable, comprehensive medical plan and continue to receive your prescriptions at your preferred pharmacy without interruption.
Open enrollment is only available until December 7th, so there’s no better time than now to begin exploring your options and rest easy knowing you will be insured and protected for 2024.
