HUGE Changes to Medicare Part D 2024 (PDP 2024)

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0:00 Intro
0:53 What is Part D?
1:59 Part D Deductible
2:32 Initial Coverage
2:55 Coverage Gap
3:06 Catastrophic Coverage
4:43 Part D Premiums 2024
6:24 Copays and Coinsurance
7:17 Part D Extra Help
7:50 Part D 2025 Final Thoughts


So, what is Medicare Part D? Part D are your prescription drug plans. Original Medicare does not cover prescription drugs except very limited drugs such as vaccines administered in a doctor’s office, chemotherapy or insulin administered via pump.
These plans are offered by private carriers but are regulated by the federal government. Plans can offer better benefits to compete for your business, but they must adhere to the federal guidelines set each year.

4 Stages
There are four stages of part D:
Deductible
Initial coverage
Coverage Gap/Donut Hole
Catastrophic Coverage

The Centers for Medicare & Medicaid Services (CMS) released Calendar Year (CY) 2024 Medicare Part D premium and bid information. This annual release provides information to help Part D plan sponsors finalize their offerings and individuals understand overall Part D premium trends ahead of Medicare Open Enrollment. The average total monthly Part D premium is projected to decrease from $56.49 in 2023 to $55.50 in 2024.

The projected average total Part D beneficiary premium is projected to decrease by 1.8% in 2024, from $56.49 in 2023 to $55.50 in 2024. The average total Part D premium is the sum of the average basic premium and the average supplemental premium for plans with enhanced coverage and is the most accurate current projection of what people will pay in 2024 for Part D premiums.

Overall, the average total Part D premium is projected to decline largely for two reasons:

The national base beneficiary premium is the starting point for calculating a plan-specific basic Part D premium. This value is calculated per a statutory formula, using a percentage of bids and estimates of reinsurance costs submitted by certain Part D plans for the statutory minimum level of coverage Part D plans are required to provide (known as the “basic” benefit). Beginning in 2024, the annual increase in the base beneficiary premium is capped by the prescription drug law’s premium stabilization provision, not to exceed 6% per year. In 2024, the premium stabilization provision reduced the increase in the base beneficiary premium by 14 percentage points; the base beneficiary premium will increase by 6% in 2024 to $34.70. Without premium stabilization, the 2024 base beneficiary premium would have been $39.35, or $4.65 higher.

With a premium stabilization-capped 2024 base beneficiary premium of $34.70, the average basic Part D premium is projected to increase from $32.09 in 2023 to $34.50 in 2024, a 7.5% increase. [2] Had the 2024 base beneficiary premium not been capped in accordance with the IRA’s premium stabilization provision, the average basic Part D premium would have increased from $32.09 in 2023 to $39.00 in 2024, a 21.5% increase.

Cost-sharing for Part D drugs will be eliminated for beneficiaries in the catastrophic phase of coverage.
The LIS, or the Extra Help, program, will be expanded so that beneficiaries who earn between 135% and 150% of the federal poverty level and meet statutory resource limit requirements will receive the full LIS that, prior to 2024, were available only to beneficiaries earning less than 135% of the federal poverty level; these subsidies provide for $0 premiums and low-cost, fixed copayments for covered prescription drugs.
Part D plans must not apply the deductible to any Part D covered insulin product and must charge no more than $35 per month’s supply of each covered insulin product in the initial coverage phase and the coverage gap phase.
Part D plans must not apply the deductible to an adult vaccine recommended by the Advisory Committee on Immunization Practices and must charge no cost-sharing at any point in the benefit for such vaccines.


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