By Joy Miller

Medicare Annual Open Enrollment from Oct. 15 to Dec. 7 is the annual opportunity to review, compare and enroll into the Medicare Part D plan of your choice.

The SHICK (Senior Health Insurance Counseling for Kansans) counseling service can provide answers to questions about Medicare and open enrollment. SHICK in Johnson County is provided by Johnson County Area Agency on Aging as a free, unbiased, confidential public service to local residents.

Medicare Part D is optional coverage for prescription drugs purchased from a retail pharmacy. Medicare beneficiaries have the option of enrolling in a prescription drug plan or a Medicare Advantage Plan that includes prescription drug coverage.

Each Medicare Part D plan option has a standard prescription coverage design with four distinct phases. The phases’ financial limits are adjusted each year. Several provisions of the Inflation Reduction Act are designed to lower prescription drug costs for Medicare beneficiaries. The provisions began in 2023, and more changes are expected in 2024.

It is common for drug plans to charge a monthly premium (fee), and the amount will vary based on the plan. Enrollees may incur an additional fee if they are assessed a Part D late enrollment penalty or have an income-related premium (IRMMA) surcharge. Others who qualify for extra help will have their premiums waived or reduced.

Starting in 2024 and continuing through 2029, Part D premiums cannot increase more than 6% a year. Extra Help eligibility also expands benefits up to 150% Federal Poverty Limit.

Jan. 1 marks the beginning of the deductible phase. Until the Part D deductible is met, Medicare Part D enrollees pay the full cost of prescription drugs. In 2024, the standard deductible will increase to $545. Some Part D plans do not charge deductibles or apply deductibles to Tier 1 or Tier 2 drugs.

Initial coverage is the second phase of Part D coverage. Enrollees will have copayments or coinsurance after the deductible is met. The amount paid depends on the tier level assigned to a drug. In 2024, the initial coverage limit will increase to $5,030. This dollar amount represents the combined spending of the enrollee and the plan (including the deductible). Over the year, if your prescription costs average $420 per month or more, you will reach the initial coverage phase limit.

The coverage gap represents the third phase. Enrollees pay no more than 25% of the covered prescription cost once this phase begins. The maximum out - of pocket expense for enrollees and pharmaceutical companies in 2024 will be $8,000 combined.

Once the $8,000 out-of-pocket limit is met, enrollees are out of the coverage gap and enter the last phase known as catastrophic coverage. Currently, an enrollee pays a small coinsurance (5%) or copay during this phase. In 2024, Medicare Part D enrollees will not have to pay copayments or coinsurance for the remainder of the year.

If you have Medicare questions or to schedule an appointment, call the Johnson County SHICK at 1-785-521-3315 or Johnson County K-State Research and Extension at 1-913-715-7000.

Information about upcoming Medicare education programs is available at johnson.k-state.edu/classes-events.

Joy Miller is a family and community wellness agent at the Johnson County K-State Research and Extension Office.