Question: I got notification that my Prescription Drug Plan coverage will no longer be offered in 2024. What happens now?

Answer: This year we have four fewer stand-alone Prescription Drug Plans (PDP’s) offered in New York state. In 2023 we had 19 plans, in 2024 there are only 15.

It sounds like you have Original Medicare, a Medicare Supplement Plan (Medigap) and a stand-alone PDP.

Let’s review some of the changes that are happening to the PDP’s in 2024.

The four PDP plans that are no longer available are two Elixir plans, and two BlueCross BlueShield plans. Elixir Rx Secure, Elixir RxPlus, Blue Rx Standard and Blue Rx Plus are the four plan names that are no longer available in 2024. Individuals who are currently enrolled in these plans for 2023 have additional time to find and enroll in a new plan, from October 15 to February 28, 2024. Enrolling into your new plan between December 8 and December 31, means your new coverage would begin 1-1-24. If you wait until after 1-1-24, you will not have prescription drug coverage for January and potentially February 2024. There wouldn’t be a penalty, but you would be without drug coverage for that period of time.

Fourteen of the fifteen plans have increased their premiums, and one plan lowered the monthly premium. Some of these increases are significant monthly increases to their premiums.

The PDP changes each year can be in the form of the monthly premiums, the way your medications are placed in tiers, what those tiers cost, and the pharmacy network. If you take very little medication or no medication, there may be a cheaper option for you in 2024.

The information on the new 2024 plans are available via the medicare.gov website, as well as 1-800-MEDICARE. These are both available 24 hours a day, seven days a week now, (any time after 10-1-23). You have the opportunity to change your coverage choice between October 15 and December 7. So, anytime is the perfect time.

There are agencies and programs available locally to help you find new insurance such as, Office For the Aging (716-753-4582), Southwestern Independent Living Center (716-661-3070). Insurance companies also have staff available (Brokers and Insurance Agents) to help you make your decisions. Remember that a broker can ONLY talk about the products they offer (that they sell).

In reviewing the standard plan for 2024, it is important to remember, your plans coverage can be different (better). The minimum coverage allows for a $545 deductible. Next is the initial coverage stage. The initial coverage period ends at $5030 in total drug costs. At $5030 in total drug cost, you enter the coverage gap, where your cost for 2024 is 25% of the retail cost of your medications. Lastly is catastrophic coverage, and the exciting news for 2024 is that during this phase your copays for all your medications will be $0 for the rest of the year. Most individuals do not take enough medication to enter the coverage gap or even close to catastrophic coverage.

If your plan is no longer available in 2024 you must evaluate the alternatives and enroll in something new to begin Jan. 1, 2024. For most of you, your current Prescription Drug coverage is available in 2024, but it is definitely worth evaluating. I have counseled many people who are paying too much for their coverage or who stay with a plan that doesn’t cover their medications adequately.

If your plan is no longer available you actually have some extra time to make your new choice, but if you wait and make a choice after Jan 1, 2024 your coverage will be delayed to the first of the following month.

You know I never recommend waiting! Good luck and Happy Insurance Season to you!

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.