America's Benefit Specialist November 2023

MEDICARE MATTERS

CMS: MEDICARE ADVANTAGE AND MEDICARE PRESCRIPTION DRUG PROGRAMS TO REMAIN STABLE IN 2024

On September 26, the Centers for Medicare & Medicaid Services announced that average premiums, benefits and plan choices for Medicare Advantage and the Medicare Part D prescription drug program will remain stable in 2024. Improvements adopted in the 2024 Rate Announcement, as well as the 2024 Medicare Advantage and Part D Final Rule, such as increased beneficiary protections around marketing and prior authorization and increased access to behavioral health, support this stability. Additionally, people with Medicare Part D prescription drug coverage will continue to have improved and more affordable benefits, including a $35 cost-sharing limit on a month’s supply of each covered insulin product, recom mended adult vaccines at no cost, and additional savings on their Medicare Part D drug coverage costs in 2024. These sav ings include the expansion of the Low-Income Subsidy (LIS) program, also called Extra Help, which helps eligible enrollees afford their premiums and cost-sharing, as well as a cap on out-of-pocket costs for millions of people with very high drug costs in the catastrophic phase of the Part D benefit. The average monthly plan premium for all Medicare Ad vantage plans, which includes Medicare Advantage prescrip tion drug plans, is projected to change from $17.86 in 2023 to $18.50 in 2024 (an increase of $0.64). If enrollees choose to stay in their plan, most will experience little or no premi um increase for next year, with nearly 73% of beneficiaries not seeing any premium increase at all. Plan choice is also increasing, and people with Medicare continue to have the ability to switch Medicare options. Medicare Advantage sup plemental benefit offerings will increase slightly in 2024. Enrollment in Medicare Advantage is projected to increase from 31.6 million in 2023 to 33.8 million in 2024. The projected Medicare Advantage enrollment in 2024 will represent ap proximately 50% of all people enrolled in Medicare, compared to approximately 48% for 2023. In addition, more than 1,500 Medicare Advantage plans will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2024, which will test the effect of offering person-centered innovative benefits that are critical to meeting healthcare needs and improving health equity to a projected 8.7 million people. The VBID Model expands access to additional supple mental benefits that can address a wide range of needs, such as food and nutrition benefits. The VBID Model offers plans the flexibility to target these benefits to people with chronic conditions or low incomes. The VBID Model’s Hospice Benefit Component, now in its fourth year, will also be offered by 78 Medicare Advantage plans in portions of 19 states and U.S. territories, providing

enrollees increased access to palliative and integrated hos pice care. CMS previously announced that the average total monthly premium for Medicare Part D coverage is projected to be approximately $55.50 in 2024. This expected amount is a decrease of 1.8% from $56.49 in 2023. To learn more about the Low-Income Subsidy Program, visit www.Medicare.gov/extrahelp. To view the premiums and costs of 2024 Medicare Advan tage and Part D plans, visit www.cms.gov/medicare/prescrip tion-drug-coverage/prescriptiondrugcovgenin. Select the various 2024 landscape source files in the downloads section of the webpage. For state-by-state information, important dates and enroll ment resources for Medicare Advantage and Part D in 2024, visit www.cms.gov/files/document/2024-ma-part-d-land scape-state-state.pdf. For more information on the Medicare Advantage Val ue-Based Insurance Design Model, including plan participa tion, visit www.cms.gov/priorities/innovation/innovation- models/vbid.

AHIP APPLAUDS BILL TO EXPAND SUPPLEMENTAL BENEFITS IN MEDICARE ADVANTAGE

More than 31 million seniors and people with disabilities choose Medicare Advantage because it delivers better ser vices, better access to care, and better value for patients and taxpayers. Recently, multiple leaders gathered to discuss the Addressing Whole Health in Medicare Advantage Act, newly introduced legislation led by Representatives Gus Bilirakis (R FL) and Earl Blumenauer (D-OR). It will expand supplemental benefits in Medicare Advantage that address health-related social needs, as well as a new report on the uptake of Medi care Advantage supplemental benefits. Representing a diverse audience, the panelists were uni fied in how these supplemental benefits are helping people get and stay healthy and how expanding the eligibility crite ria for Medicare Advantage supplemental benefits will help even more Americans improve their health. Event attendees included leaders from Mom’s Meals, the Elevance Health Public Policy Institute, AHIP and the Coa lition for Medicare Choices. Representative Bilirakis kicked

24 ABS | benefitspecialistmagazine.com