It’s that time of year again. Time to polish up your reading glasses and start dissecting the latest changes and adjustments to your Medicare coverage. As tedious as the process can sometimes be, reviewing your coverage and the upcoming changes really is the only way to ensure that you’re getting the most out of your Medicare coverage.
There’s a lot of good news to go around heading into 2023 too. From capping insulin copays to reduced premiums and deductibles for Part B coverage, you’re sure to enjoy the incoming changes. So let’s take a closer look at the major changes coming to Medicare in 2023.
Jim Vallee/ShutterstockMedicare Basics
Medicare is a program funded and administered by the federal government. It’s designed to provide health insurance for people over the age of 65, younger people with disabilities, and those with permanent kidney failure requiring dialysis or a transplant, commonly called end-stage renal disease.
Coverage is broken up into parts, each crafted to cover a different category of medical expenses.
- Part A is commonly called hospital insurance and covers inpatient care, hospital status, hospice care, and some home healthcare.
- Part B, or medical insurance, covers medical supplies, various preventative services, and outpatient care.
- Part D helps cover the costs of prescription drugs.1
Despite what people may think, Medicare isn’t free. Though some Americans don’t pay a monthly premium for Part A, many do. Parts B and D always require monthly premiums, and Part D comes with copays that require the individual to pay a portion of the cost of most drugs.
Medicare Part B Premium and Deductible
The good news starts with a reduction to the standard premium for Medicare Part B. The monthly premium totalled $170.10 in 2022, but is set to decrease to $164.90 per month beginning in January of 2023. And, for the first time since 2012, the Part B deductible is set to go down too. This year’s deductible will be $226, which is down from $233 a year before.2
Medicare Part A Premium and Deductible
Unfortunately those required to pay a premium for Part A will notice an increase from 2022. The new premium for 2023 will be $278 a month, which is a $4 increase from the 2022 rate. The deductible for Part A is subject to rise too. What was $1,556 in 2022 will increase to $1,600 in 2023.
New Start Dates for Your Medicare Coverage
Eligible first-time enrollees will be able to enjoy their coverage earlier in 2023. Beginning on January 1, 2023, those that sign up for Medicare in the month that they turn 65 or during the last 3-months of their initial enrollment period, or during the general enrollment period, will start receiving coverage the first day of the month following sign up.3
Kidney Transplants and Immunosuppressive Drug Coverage
Before this latest adjustment, Medicare eligibility for kidney transplant recipients would expire after 36-months. That policy officially changes in 2023. Beginning on January 1st, kidney transplant recipients can continue to receive limited Medicare Part B coverage to help cover the cost of the immunosuppressive drugs they need, for as long as they need.
Insulin Copays Will Be Capped
This year ushers in a monumental change for Medicare enrollees that rely on insulin. Thanks to the Inflation Reduction Act that was passed earlier this year, insulin copays will be capped. Beginning on January 1, 2023, the cost of insulin will be capped at $35 a month!
There are over 1.7 million Medicare Part D enrollees that rely on insulin. In 2020, these enrollees spent an average of $54 per prescription, with many paying as much as $100. Capping those costs at $35 per month will make a substantial difference to those enrollees and their families moving forward.4
COVID-19 Updates
Though it’s not technically a new development, the continuation of COVID-19 coverage into 2023 bears mentioning here. As was the case in 2022, Medicare will continue to cover the cost of treatments, vaccines, booster shots, and tests eligible Medicare enrollees.
This particular coverage may change in the event that the public health emergency status changes. But until that happens, expect more of the same in 2023.
Another Time to Sign up for Medicare
Those that missed enrolling during the Medicare’s open enrollment period may qualify for enrollment during the brand-new special enrollment period. New for 2023, the special enrollment period will be introduced to protect those who were unable to enroll due to a specific set of exceptional circumstances, including natural disasters, incarceration, an emergency, or after losing Medicaid coverage.
Don’t Wait to Review Your Coverage
Medicare is going to look different in 2023. From capping insulin costs, lower Part B premiums and deductibles, and new start dates taking effect on January 1st, there’s a lot to consider! All the more reason to take this time to review your coverage and make the necessary adjustments.
Medicare open enrollment starts on October 15, 2022 and ends on December 7, 2022. Apart from a few extreme exceptions, this will likely be your only chance to change your coverage. It’s up to you to use this time to ensure that the coverage t you receive meets your expected needs in 2023.