By Deborah Jeanne Sergeant
If you receive Medicare, look for these changes coming in 2024:
• Premium increases
“As far as it relates to Medicare itself, you’ll see a slight increase in premiums for Part B and slight changes to the deductibles,” said John Kulakowski, NYS licensed insurance agent and founder and CEO for Senior Advisory Insurance Services in Cicero. “Medicare Advantage plans will see conservative changes and very few increases in ancillary benefits like dental, vision and hearing. Medicare supplements will show increases in premiums. Their benefits aren’t changing much.
“The part D drug supplement plans will show for the most part spikes in premiums and higher cost shares for drugs, which is not a good thing. The supplement way may not be a good option if they want to conserve on premiums.”
• New Medicare supplement look-alike plans
“They are higher-premium Advantage Plans with zero copays and better coverage,” Kulakowski said. “Drugs would be in the plan. It may include dental, vision and hearing which the Medicare supplements don’t.
“You have to be careful. If you have cancer with radiation or chemotherapy, you would still have to pay 20% coinsurance. If someone wanted to go to one of these plans and they go to specialists a lot they’d have zero copays, but someone with kidney dialysis or cancer, high maintenance types of illnesses, they’d want to stay with the supplement.”
• No more catastrophic stage for the “doughnut hole”
The “doughnut hole” that pertains to Part D prescription plans and Advantage Plans with prescription drug coverage will no longer have the catastrophic stage.
“Someone gets into the ‘doughnut hole’ when the total cost of the amount of their medications once they reach $5,030,” said Theresa Cangemi, Medicare specialist. “When they enter the doughnut hole at $5,3030, they will pay 25% of the total cost of their medications until they reach a total cost of $8,000. In 2024, they won’t owe anything after the catastrophic stage or $8,000, which has changed from the 2023 ‘doughnut hole’ requirements.”
Cangemi operates Retirement Health Plans Made Simple, formerly called Medicare Made Simple, LLC in Syracuse.
• All-in-one cards
“For 2024, the biggest thing and–it’s mostly for those with Medicaid–is that there’s an all-in-one card with a food allowance, utilities allowance, over-the-counter items, gas allowance and it could cover extra transportation. But it’s typically for those on Medicare and Medicaid. Not all of these benefits are offered with all insurance companies or all Medicare Advantage Plans. These benefits will also depend on the area that someone lives in and will depend on their income.”
• More over-the-counter
“That allows you to buy things medically related like Band-Aids, aspirin or cough and flu medication,” said Lee Kern, licensed insurance agent and owner of NY Medicare Specialists in Rochester and Buffalo.
This can lower costs for everyday items that help support good health.
• More lifestyle inclusions
“Some plans have allowed that for healthy foods, pet food and utilities,” Kern said. “It’s a lifestyle benefit. Some of the lower income supporting plans have transportation for beneficiaries.”
Transportation benefits can help recipients stay current with visits to healthcare providers and seek preventative health.
He added that some new plans provide gift cards for recipients who schedule a check-up in their homes. Another offers rewards to enrollees who track their steps with an app and record sufficient steps. Lifestyle inclusions are all about promoting healthy living.
• More plan counseling
“They require us to go over plan benefits with clients and make sure their doctors are within their plans, and to go over the formulary and explain benefits,” Kern said.
Although that’s how he’s always operated his office, the review service is now a requirement for agents.
“I don’t see how you could provide good service without doing this,” he added, “because it changes each calendar year. People have to look at their annual notice of change.
“It’s about finding a plan that will provide the right coverage if you’re planning on traveling. Understand the cost of a surgical procedure. If you’re using a network facility, usually, that is covered. I have a license in Florida and it seems they have a lot of fragmentation within the system.”
James advises people to talk with a local agent rather than responding to an advertisement on TV or the radio, since sometimes they may be calling a national call center operated by people who are not related to their local area.