What changes are coming to Medicare in 2024?

Asked by: Raheem Boyer  |  Last update: October 22, 2025
Score: 5/5 (72 votes)

In 2024, changes include the expansion of full Extra Help and elimination of cost sharing during the catastrophic coverage phase of Part D. Extra Help is a federal cost assistance program that helps with the cost of Medicare Part D, the prescription drug benefit.

What changes in Medicare for 2024?

Expansion of the federal Extra Help program

Historically, there have been two versions of the program, the full program and a partial program. As of January 1, 2024, the partial program was eliminated. With full benefits, the majority, if not all, out-of-pocket costs for prescription medications will be covered.

Is the Medicare donut hole going away in 2024?

In 2025, the Medicare Part D coverage gap, also known as the “donut hole,” will be eliminated under the Inflation Reduction Act (IRA). Part D plan members will also enjoy the security of an annual maximum out-of-pocket cost for prescription drugs.

What are the extra help changes for 2024?

Starting January 1, 2024, you'll pay <up to $1.55 or $4.60 for generic drugs and up to $4.50 or $11.20 for brand-name drugs or $0> for each covered prescription you fill at one of your Medicare drug plan's participating pharmacies.

Who is eligible for the 2024 subsidy program?

In or after 2024, to be eligible for a full (100%) premium subsidy, the individual must have countable income less than 150% of the FPL for the applicable State and family size. Before 2024, the individual's countable income must be less than 135% of the FPL for the applicable State and family size.

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How do you qualify to get $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

What is the new Medicare rule for 2025?

Medicare Part B Premium and Deductible

The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, an increase of $17 from the annual deductible of $240 in 2024.

How do I avoid the Medicare donut hole?

Discuss lower-cost drug alternatives with your healthcare professionals. Seek out discounts on medications. Choose generic drugs over brand-name drugs. Opt for in-network pharmacies only.

What happens to Medicare in 2026?

For the first time, Medicare is able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don't have competition. Prices have been negotiated for the first 10 drugs selected and will be effective in 2026.

How much will Medicare premiums increase in 2024?

The standard monthly premium for Medicare Part B enrollees will be $174.70 for 2024, an increase of $9.80 from $164.90 in 2023. The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023.

What is the highest income to qualify for Medicaid 2024?

Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.

Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Why are people dropping Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

How much will the Medicare Part D plan cost in 2024?

Part D cost sharing

A monthly Part D plan premium (average estimated premium in 2024 is $46.50) An annual deductible (maximum $590 in 2025) A copayment or coinsurance during the initial coverage period.

Can I drop my medicare advantage plan and go back to original Medicare?

Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.

Is there a coverage gap in Medicare 2024?

The Medicare Part D donut hole or coverage gap phase of coverage no longer exists as of December 31, 2024. It was the coverage phase after the initial coverage period when you owed a higher or different percentage of the cost of your drugs.

Can I use GoodRx if I'm in the donut hole?

Key takeaways:

You may want to consider using GoodRx instead of Medicare when Medicare doesn't cover your medication, when you won't reach your annual deductible, or when you're in the coverage gap phase (“donut hole”) of your Medicare plan.

How do you beat the donut hole?

How do you close the coverage gap and get out of the donut hole?
  1. Lower the costs of your prescription medications by choosing a Part D plan with a formulary that includes your medications.
  2. Shop around to see if you can find a pharmacy that offers your medications at a lower cost.

What's new for Medicare in 2024?

Starting January 1, 2024, Medicare will cover mental health care services provided by marriage & family therapists and mental health counselors.

Why do people say not to get a Medicare Advantage plan?

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

What year will Medicare end?

A key trust fund underpinning the massive Medicare program has a new insolvency date: 2036, according to a new report from the Medicare trustees.

How much money can you have in the bank if you're on Medicare?

eligibility for Medi-Cal. For new Medi-Cal applications only, current asset limits are $130,000 for one person and $65,000 for each additional household member, up to 10. Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information.

What is the Medicare Part B premium for 2024?

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $185.00 in 2025, an increase of $10.30 from $174.70 in 2024.

What does Social Security extra help pay for?

The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.