What to Expect: Utah Medicare


Posted by: Altura Benefits in Insurance

Utah Medicare
It’s time to pick your Medicare plan for 2024 – beneficiaries have many options to choose from. The plan you select will impact both your coverage and your costs. Here’s what to expect from Utah Medicare plans.

The Medicare Fall Open Enrollment

Every year, Medicare enrollees have the opportunity to change their Medicare enrollment for the coming year. The fall open enrollment period (also called the Medicare Annual Enrollment Period or AEP) takes place between October 15 and December 7. The plan selection you make during this period will take effect on January 1.

Enrollees have two types of Medicare plans to choose from during the fall:

  • Medicare Advantage plans combine Medicare Parts A and B into a single plan, often with additional benefits. If you are only enrolled in Original Medicare, you can use the fall open enrollment period to switch to Medicare Advantage. If you are currently in a Medicare Advantage plan, you can switch to a different plan.
  • Medicare Part D plans provide prescription drug coverage. If you are only enrolled in Original Medicare, you can enroll in a Medicare Part D plan to obtain prescription coverage. Most Medicare Advantage plans include prescription drug coverage, so adding a Part D plan is usually not necessary.

2024 Medicare Advantage Costs

The average national Medicare Advantage monthly premium will be $18.50 in 2024, according to CMS. In 2023, it was $17.86, meaning the increase is only $0.64. Many plans are not increasing their premiums at all – 73% of beneficiaries who stay in their current Medicare Advantage plan can expect no premium increase.

However, it’s important to remember that people who enroll in Medicare Advantage still have to pay the Medicare Part B premium. The standard monthly Medicare Part B premium is $164.90 in 2023, and a Medicare Trustees report predicts it will rise to $174.80 for 2024.

2024 Medicare Part D Costs

Average Medicare Part D prescription drug plan costs are going down in 2024. CMS says the average national monthly premium is expected to be $55.50, which is a decrease of 1.8% from 2023, when the average monthly premium was $56.49.

Medicare Coverage Options Keep Increasing

Medicare Advantage and Part D plans are offered by private insurance companies. As a result, there is considerable competition between insurance carriers, and Medicare enrollees have many plan options to choose from.

Selecting the right plan is important because coverage and costs can vary significantly. For example, most Medicare Advantage plans use networks of providers. If you see a doctor who is not in your network, you could end up paying a lot more in out-of-pocket costs. It’s therefore important to review a plan’s network before enrolling. Benefits also vary. Many Medicare Advantage plans offer prescription drug coverage, hearing, dental, vision, and gym membership. However, since not all do, you need to decide which benefits matter most to you and look for a plan that offers these.

Thankfully, new Medicare Advantage plans keep coming onto the market. With more plans to choose from, it’s increasingly easy to find the perfect match. According to KFF, the average Medicare beneficiary had 43 Medicare plans to choose from in 2023. This is a significant increase compared to recent years. For example, the average enrollee had 28 plans to choose from in 2020 and 17 to choose from in 2015.
There are also more Special Needs Plans, catering to specific populations of enrollees. For example, Dual-Eligible Special Needs Plans serve individuals who are eligible for both Medicare and Medicaid, whereas Chronic Conditions Special Needs Plans serve individuals with specific health conditions, such as cancer or diabetes. In 2023, there were 1,284 Special Needs Plans, according to KFF – up from 1,156 in 2022 and 975 in 2021.

Although some Medicare enrollees decide to stay in Original Medicare – possibly with a Medicare Supplement Insurance (Medigap) plan – more enrollees are opting for Medicare Advantage. According to CMS, 31.6 million Medicare beneficiaries chose Medicare Advantage in 2023. In 2024, 33.8 million Medicare beneficiaries are expected to enroll in Medicare Advantage.

Medicare Coverage Options in Utah

Although the number of Medicare plans keeps growing, some areas have more plan options than others. In general, highly-populated urban areas have more plan options than rural areas.

According to KFF, the Utah counties of Salt Lake, Utah, Box Elder, Tooele, Weber, Morgan, and Davis had between 21 and 40 Medicare Advantage plan options in 2023. All other counties had between one and 20 plan options. This is a notable improvement from 2018, when several Utah counties had zero Medicare Advantage plan options, and none had more than 20 options.

If this trend continues, Utah Medicare beneficiaries can expect to see even more options in 2024. In fact, Fierce Healthcare says several carriers are planning to expand their plan options for 2024.

Medicare Coverage Updates for 2024

Medicare coverage has undergone several changes recently. Many will be in effect for the 2024 plan year, including:

  • A month’s supply of insulin is capped at $35. Medicare Part B covers insulin if you use an insulin pump. Otherwise, Medicare Part D covers insulin. Either way, your insulin costs are now capped at $35 a month or $105 for a three-month supply.
  • Recommended adult vaccines are available with no out-of-pocket costs. According to the CDC, Medicare now covers all adult vaccines recommended by the Advisory Committee on Immunization Practice at no cost. This includes the RSV and shingles vaccines. Medicare Part B covers some vaccines, including those for COVID, hepatitis B, flu, and pneumococcal disease. Medicare Part D covers other vaccines.
  • The Extra Help program is expanding. The Extra Help program provides financial assistance to qualifying individuals who need help affording their prescription drug coverage. CMS says the program is expanding in 2024. Everyone who qualifies will have a $0 drug plan premium and deductible as well as reduced copays. Find out if you qualify by applying at https://www.ssa.gov/medicare/part-d-extra-help.

Selecting a Utah Medicare Plan for 2024

The Medicare fall open enrollment period is your opportunity to make sure you have the best plan for your needs. Don’t let this opportunity pass you by! Even if you’re happy with your Medicare plan, you should take the time to explore your options.

  • Review your Medicare Annual Notice of Change. Your current plan should have sent you this in September. It’s an important document that outlines any changes to your plan’s costs and coverage for the upcoming year. You may be happy with these changes, or you may decide the plan no longer fits your needs.
  • Look for new plans in your area. As insurance carriers expand their offerings, you may have new plans to choose from. In addition, some existing plans may have changed their coverage.
  • Check the network. Seeing a provider from outside your network can be expensive. Since networks can change, make sure your providers are still in your plan’s network or in the network of any plan you’re considering.
  • Check the formulary. Most prescription drug plans use a formulary that states which prescriptions it covers and how much you’ll pay for them. Check your prescriptions to ensure the plan provides coverage for all of them.
  • Add up all your costs. Your premium is only a small part of the total you’ll pay. When comparing plans, include your premium, deductible, and copay for the coverage you think you will need. Also factor in the value of additional benefits – such as dental coverage – that a plan provides.

Comparing Utah Medicare plans can be overwhelming, but you don’t have to do it alone. Altura can help. Contact us.