Medicare recently announced the Part D and Extra Help costs for 2024. Medicare sets the standard Part D costs, but Part D plans can structure their benefits differently as long as their costs are actuarily equivalent to the costs Medicare outlines in their standard Part D benefit. Most Part D plans do structure their cost-sharing differently from the standard coverage by lowering or taking away the deductible and placing drugs on tiers with lower tier drugs costing less than higher tier drugs. Plans typically use the thresholds set out in the standard benefit to move people through the various coverage phases of Part D.
People with limited incomes and resources can apply for Extra Help with Medicare prescription drug costs. Extra Help limits what people pay for their Part D coverage and medications. The Extra Help program is also called Low-Income Subsidy or “LIS”. Anyone with Medicare who gets any benefit from Medicaid, including payment of the Medicare Part B premium) automatically gets Extra Help!
The 2024 Part D premium people pay will vary by plan and depends on whether they get Extra Help. The national Part D base premium for 2024 will be $34.70 and premiums for Part D coverage in Pennsylvania next year range from $.50 to $108.80. Medicare Advantage plans (which have a health premium and a drug premium) range from $0 to $295. People with Extra Help will pay $0 premium if they enroll in a zero premium Prescription Drug Plan. Otherwise, the premium cost for people with Extra Help will depend on what, if any, amount of their plan’s premium is not covered by Extra Help. Extra Help will cover up to $40.16 of standard Part D plan premium costs next year. The table below shows Part D costs with and without Extra Help.