Important Updates: Medicare Changes Affecting Local Seniors and Disabled Residents

Medicare’s annual open enrollment period is currently underway. This federal health program serves older individuals and those with disabilities. From October 15 to December 7, the 65 million people enrolled in Medicare can make changes to their coverage. This includes members of the traditional Medicare program and Medicare Advantage, which is provided by private insurers. New enrollees typically sign up within a few months of turning 65, regardless of the enrollment season.

The 2024 enrollment period brings new features, such as reduced out-of-pocket expenses for certain expensive medications. Experts recommend that beneficiaries review their current coverage because there may be changes in their network’s pharmacies, medical providers, and prescription costs. Bonnie Burns, a consultant from California Health Advocates, advises a thorough examination of these changes.

Understanding the differences between traditional Medicare and Medicare Advantage is important. Traditional Medicare allows access to any affiliated doctor or hospital, while Medicare Advantage requires choosing from a provider list specific to the plan. Traditional Medicare does not cover prescriptions, so enrollees may want to consider Part D, the optional drug benefit. Most Medicare Advantage plans do include drug coverage, but it’s essential to confirm this before enrolling.

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For individuals aged 65 or older who are enrolling in traditional Medicare for the first time, they can purchase a supplemental policy known as ‘Medigap.’ This policy covers out-of-pocket costs like deductibles and copays. However, for those switching from Medicare Advantage to traditional Medicare during the open enrollment period, obtaining a supplemental Medigap policy can be challenging. Private insurers that offer Medigap plans may deny applicants with health issues, increase premiums, or limit coverage for preexisting conditions, with a few exceptions.

Lastly, there have been improvements in drug coverage. For those who require expensive medications, some costs will be eliminated in 2024 due to President Joe Biden’s Inflation Reduction Act. This new policy sets an annual limit on out-of-pocket drug costs for Medicare beneficiaries. Tricia Neuman, the head of the KFF Medicare policy program, believes this will be of great assistance to individuals with conditions like cancer, rheumatoid arthritis, and hepatitis, who require costly medications.

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