The Senior Citizens League (TSCL) Monthly Washington Update for the end of October 2023
Medicare Open Enrollment Period Has Begun
In case you haven’t heard, the Medicare open enrollment period has started, and it runs through Dec. 7. This is when Medicare enrollees can make changes to their coverage effective for the 2024 plan year, including changes to their Medicare prescription drug coverage.
It is important that you pay attention to the open enrollment period by:
- Opening and studying the Annual Notice of Changes. You should have received it by now. If not, contact your plan.
- Focusing on Section 1, Changes to Benefits and Costs for Next Year, especially the prescription drug cost changes in Section 1.3.
- Determining the impact on your costs and coverage.
- If a new plan will work better or save money, enroll in it by the end of November. Although you technically have until the open enrollment period ends on Dec. 7, experience indicates that those who wait until the very end frequently have some sort of problem.
Some new features regarding Medicare Part D drug coverage for 2024 include:
- Insulin: All insulins covered under Part D, whether injected or administered by pump, are capped at $35. To get an idea of the savings, 3.3 million beneficiaries with Part D coverage in 2020 spent $1 billion out of pocket on insulin.
- Part D vaccines: There is no copayment for vaccinations, such as shingles (known as Shingrix), hepatitis B administered to non-high-risk individuals, DTaP (diphtheria, tetanus, pertussis), RSV (respiratory syncytial virus) and others.
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TSCL Endorses Drug Price Transparency Legislation Introduced in Congress
U.S. Representatives Abigail Spanberger (D-Va.) and Zach Nunn (R-Iowa) have recently introduced bipartisan, bicameral (House & Senate) legislation to require pharmaceutical companies to disclose the price of their drugs in advertisements.
Advertising expenses by drug manufacturers have more than quadrupled over the past two decades — rising from $1.3 billion spent on 79,000 ads in 1997 to $6 billion spent on 4.6 million ads in 2016. According to the Government Accountability Office (GAO), prescription drugs advertised directly to consumers account for 58 percent of Medicare’s spending on drugs. As a result, an American sees an average of nine pharmaceutical advertisements each day — often steering patients to more expensive drugs, even when a low-cost generic is available. Most countries have banned direct-to-consumer prescription drug advertising altogether — the United States and New Zealand are the only countries in the world that allow direct-to-consumer pharmaceutical advertising.
The bipartisan Drug-Price Transparency for Consumers Act would require direct-to-consumer pharmaceutical advertisements to include a disclosure of pricing information. Specifically, the legislation would amend the Social Security Act to allow the Secretary of the Department of Health and Human Services (HHS) to require that pharmaceutical advertisements disclose the wholesale cost for a 30-day supply or typical course of treatment of the drug, clearly present the price information, and explain that pricing may vary depending on insurance coverage. Additionally, the bill would subject advertisers to a penalty of up to $100,000 for each violation.
On the other side of the Capitol, U.S. Senators Dick Durbin (D-IL) and Chuck Grassley (R-IA) lead the U.S. Senate version of the Drug-Price Transparency for Consumers Act (S.1250).
The Senior Citizens League is pleased to have endorsed this important legislation, and we will fight for its passage in Congress.
TSCL Prediction is Correct: 2024 Social Security COLA will be 3.2%; Medicare Announces 2024 Premium Hike
As TSCL’s analyst Mary Johnson predicted, the government announced that the Social Security COLA for 2024 will be 3.2%.
That amounts to, on average, another $50 or so a month, bringing the average Social Security check for all retired workers to $1,907 in the coming year.
In addition, Medicare has announced that the standard monthly premium for Medicare Part B enrollees would rise by about $10 to $174.70, and the annual deductible would increase by $14 to $240. Among other increases, a senior admitted to the hospital will see the Medicare Part A inpatient hospital deductible rise by $32 to $1,632.
Here are some additional points to be aware of:
* Medicare enrollees may see higher premiums based on their income.
* The deductible for Medicare Part A, which covers inpatient hospital care, nursing home stays, and other services, will be $1,632 next year – a $32 or 25 increase from this year.
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It is Important that You have Prescription Drug Coverage
Open enrollment season is the time of the year when you can make changes to your prescription drug coverage.
If you’re eligible for Medicare and don’t have creditable drug coverage, which means drug coverage that is at least as good as Medicare drug coverage, you will be hit with a 1 percent late enrollment penalty for every month you were eligible for Medicare drug coverage but didn’t enroll.
If, for example, you don’t have drug coverage for ten months, you could be hit with a 10 percent increase in your Medicare drug plan premiums if you do eventually sign up for a Medicare drug plan. And you’ll continue to pay that 10 percent penalty every single month, every single year that you have Medicare drug coverage.
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Senate Committee Investigate Medicare Advantage Enrollment Schemes
In our September update, we wrote about a video conference TSCL participated in that discussed the Medicare Advantage (MA) ads that inundate TV and mailboxes every fall during open enrollment season.
We learned that there were over 650,000 of the ads last fall.
In addition, we reported that “There is a lot of confusion about the ads because, among other things, there are more than 40 MA plans.
“It was no surprise to learn that there are deceptive things in the ads, including calling the number they give a “Medicare hotline” or a “Medicare number,” when those numbers are actually private numbers that reach insurance agents or brokers.
“For the first time this year, CMS [the Centers for Medicare and Medicaid Services] is reviewing all of the ads that will be shown on TV or social media. The companies that sponsor the ads are forbidden to picture an actual Medicare card or refer to their phone number as a ‘Medicare number.”’
A Senate committee is investigating those ads to determine how private insurers advertise them to seniors.
This comes about as CMS has noted an increase in complaints about confusing and potentially misleading ads as MA enrollments have surged.
For progress updates or more information about these and other bills that would strengthen Social Security and Medicare programs, visit our website at www.SeniorsLeague.org or follow TSCL on Facebook or Twitter.