We’re coming up on Medicare enrollment season and that means seniors will likely get bombarded by advertisements for supplemental insurance and a big, who-wants-to-read-all-of-this "Medicare and You" book from the agency explaining everything in detail.
If you’re already a Medicare subscriber, ConsumerAffairs has plowed through that book -- which every subscriber should receive by mid-October -- and boiled down what’s new and interesting about coverage beginning in January of 2024. Here we go…
Chronic pain management and treatment services.
“Medicare covers monthly services for people living with chronic pain (persistent or recurring pain lasting longer than 3 months),” is how Medicare explains this new perk. Services may include pain assessment, medication management, and care coordination, as well as planning. The Part B deductible and coinsurance apply.
Lymphedema compression treatment items
For those suffering from lymphedema, beginning January 1, 2024, Medicare will cover your prescribed gradient compression garments (standard and custom fitted). You pay 20% of the Medicare-approved amount. The Part B deductible applies here as well.
Mental health treatment
Kicking off the new year, Medicare will also cover mental health care that subscribers may get from both marriage and family therapists and mental health counselors.
“Covered mental health care includes partial hospitalization services given by a community mental health center or by a hospital to outpatients. Partial hospitalization is a structured day program that offers outpatient psychiatric services as an alternative to inpatient psychiatric care,” the new Guide explains.
For those who need more rigorous mental outpatient program services than they might get from a therapist – the type provided by hospitals, community mental health centers, federally qualified health centers, and Rural Health Clinics – Medicare is stepping in to help there, too. Visit Medicare.gov/coverage/mentalhealth-care-partial-hospitalization to learn more.
As far as cost is concerned, the agency says that, generally, you pay 20% of the Medicare-approved amount and the Part B deductible applies for mental health care services. Part A covers inpatient mental health care services you get in a hospital.
Medicare now covers telehealth
You can’t say that Medicare’s dragging its feet when it comes to technology’s developing role in a consumer’s life. Through December 31, 2024, you can get telehealth services at any location in the U.S., including your home.
However, after this period, there will be two exceptions:
You must be in an office or medical facility located in a rural area for most telehealth services.
You’ll still be able to get certain Medicare telehealth services wiithout being in a rural health care setting. They include:
Monthly End-Stage Renal Disease (ESRD) visits for home dialysis
Services for diagnosis, evaluation or treatment of symptoms of an acute stroke wherever you are, including in a mobile stroke unit
Services to treat a substance use disorder or a co-occurring mental health disorder -- sometimes called a “dual disorder” -- or for the diagnosis, evaluation, or treatment of a mental health disorder, including in your home
Behavioral health services, including in your home
You pay 20% of the Medicare-approved amount for your doctor or other health care provider or practitioner’s services. The Part B deductible applies. For most of these services, it’s important to note that you’ll pay the same amount you would if you got the services in person.
Plans and cost changes
There’s a good number of changes when it comes plans, changing plans, Medicare vs. Medicaid vs. Medigap, etc. – changes too numerous to detail here and things that a Medicare representative can take care of via chat or phone.
One of those that is worth noting is starting January 1, 2024, once your out-of-pocket spending reaches $8,000, (including certain payments made by other people or entities, including Medicare’s Extra Help program, on your behalf), you won’t have to pay a copayment or coinsurance for covered – and typically expensive – Part D drugs for the rest of the calendar year.
Those drugs include HIV/AIDS treatments, antidepressants, antipsychotic medications, anticonvulsive treatments for seizure disorders, immunosuppressant drugs.