8 Medicare Changes to Expect in 2024, Like the Expansion of Mental Health Coverage

A new year means new changes to your Medicare coverage.

On the one hand, in 2024, you can expect to see higher premiums and deductibles on Part B plans and fixed copays for Part D Extra Help enrollees. On the other hand, Extra Help enrollees won’t have to pay partial premiums anymore, and everyone will enjoy caps on their out-of-pocket costs for Part D prescriptions. There are also a few areas of expanded coverage, like chronic pain, mental healthcare, and compression treatment.

Let’s get into it.

8 Medicare Changes to Expect in 2024

1. Part B premiums are going up in 2024.

This isn’t incredibly surprising. Most years, Medicare premiums go up. Last year, they went down for the first time in over a decade. It was a correction for the incredible 14% increase in Part B premiums we saw in 2022 – that year Part B premiums jumped up from $148.50 to $170.10. The increase was attributed to a new Alzheimer’s drug that didn’t end up having nearly as much demand as the government was anticipating.

Last year’s correction brought standard Part B premiums down to $164.90. But for 2024, they’re back up to $174.70.

2. Out-of-pocket costs will be capped for Part D enrollees. 

Right now, you have to pay 5% coinsurance for your drugs with Part D coverage when you’re in the catastrophic category. In 2024, that requirement will be removed.

Instead, drug expenses will be capped at $8,000 per year, with no copays if you reach the catastrophic level. That $8,000 cap includes the value of any discounts that have been issued by the drug manufacturer. So in practice, Part D recipients will see out-of-pocket costs max out somewhere around $3,100 – $3,300 if you’re taking name-brand prescriptions. This is a big deal – it can result in savings of thousands to even ten thousand dollars for some enrollees.

If you’re on the right types of medication and qualify for the low-income subsidy program, contributions from the Extra Help program will count towards the $8,000 cap, too.

3. The Extra Help program is about to be 100% premium free. 

In 2024, the low-income subsidy program (or Extra Help program) gets even better. Right now, if you qualify, there’s the potential that you could only qualify for partial assistance. But from 2024 onward, if you qualify for Extra Help at all you’ll be on the free program. Period. No premiums. No deductibles. And fixed low co-pays for certain medications.

To qualify for Extra Help in 2024, you have to make under 150% of the federal poverty line (FPL). For this enrollment period, 150% of the FPL is $21,870 for an individual or $29,580 for a married couple. There’s also an asset test, but it doesn’t count certain things like your housing or up to $15,000 you have saved for burial expenses. After the allowable assets, the max extra you can have is $16,600 for an individual or $33,240 for married couples.

4. Fixed copays are going up by less than $1 for Extra Help enrollees. 

While you will score those fixed copays as an Extra Help enrollee, those co-pays are going up a little in 2024. Not by too much – less than $1 per prescription. Here’s how the numbers will change:

5. Have chronic pain? It’s now covered under Part B. 

If you’ve been having chronic pain for at least three months, Medicare will now cover pain assessment, medication management, and care coordination. You’re still going to have to pay your Part B deductible and coinsurance, but it’s a big deal that it’s getting covered at all. It’s especially good news in light of long COVID.

6. Mental health coverage expands in 2024. 

Currently you can get outpatient mental health care through Medicare, including accessing professionals like psychiatrists, clinical psychologists, clinical nurse specialists, clinical social workers, nurse practitioners, or physician assistants. In 2024, that list expands to include mental health counselors, marriage counselors and family counselors.

Medicare will also start covering intensive inpatient mental health services like you might find inside a hospital, community mental health center or a rural health clinic. If that sounds too intense for you, but you also need more care than meeting with a therapist for an hour a week, Medicare will newly cover partial hospitalization, too, which operates more like a day program – but you still get to go home and sleep in your own bed every night.

Depending on where you’re getting services, you typically pay 20% of the Medicare-approved cost of the mental health services, and your Part B deductible still applies.

7. Compression treatment covered for lymphedema patients in 2024.

Lymphedema is when you have so much lymph fluid built up in your body that it causes swelling. Compression treatments can help, and they’ll be covered starting on January 1, 2024. Once again, you’ll take on 20% of the cost and factor it into your Part B deductible.

8. The last year to get telehealth services is 2024.

This will be the last year you can get telehealth covered through Medicare under all circumstances (albeit while shouldering 20% of the costs and in consideration of your Part B deductible.) After December 31, 2024, you’ll only be able to get these services covered if you’re in a rural area or if you need any of the following services – regardless of where you live:

• Behavioral health services.
• Mental health services – including substance use disorder.
• Diagnosis, evaluation or treatment of a stroke.
• Monthly ERDS visits for home dialysis.

Pittsburgh-based writer Brynne Conroy is the founder of the Femme Frugality blog and the author of “The Feminist Financial Handbook.” She is a regular contributor to The Penny Hoarder.