A new year means changes to Medicare, including updated premiums and deductibles and sometimes big policy moves. In 2023, there’s a little of everything: Some costs have gone down, others have increased, and there are some notable tweaks to how Medicare works.
Understanding what’s new can help you get the most from your Medicare benefits. Here are some key 2023 updates, according to the Centers for Medicare & Medicaid Services.
Part B costs have gone down
Medicare Part B is medical insurance that covers needs like doctor visits and durable medical equipment, such as wheelchairs and walkers. Everyone pays a Part B monthly premium, even people with Medicare Advantage plans.
In 2023, the Part B standard premium is $164.90 per month, down from $170.10 per month in 2022. If you have a higher income, you may pay more. The Part B deductible dropped to $226 in 2023, down from $233 in 2022.
Part A costs have gone up
Medicare Part A is hospital insurance that covers inpatient stays in a hospital or skilled nursing facility. Most people don’t pay a premium for Part A, but for those who do, those premiums increased to $506 per month, up from $499 in 2022. And the deductible for a hospital stay is $1,600 in 2023 for each benefit period, up from $1,556 in 2022.
Copays for inpatient stays in hospitals and skilled nursing facilities are also up. These are costs per benefit period:
$400 per day for days 61 to 90 in a hospital (up from $389).
$800 per “lifetime reserve day” after day 90 in a hospital, up to a limit of 60 days in your lifetime (up from $778).
$200 per day for days 21 to 100 in a skilled nursing facility (up from $194.50).
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Insulin costs are capped
New this year, insulin costs are limited to $35 a month for Medicare beneficiaries, and there is no deductible. Although the change went into effect Jan. 1, insurance plans have a deadline of March to put this system in place. If you pay more than $35 a month for insulin in January and/or February, ask your plan about reimbursem*nt for the overage.
Starting in July, insulin used with a traditional pump covered by Medicare will also be capped at $35 for a month’s supply.
Medicare start dates have shifted
It used to be that for certain Medicare sign-up times, your coverage started two to three months later, which could cause gaps in health care. Starting this year, those dates have changed.
If you sign up for Medicare the month of your 65th birthday or during the three months after, your coverage now starts the month after you sign up. Similarly, if you sign up for Medicare during the general enrollment period from Jan. 1 to March 31 each year, your coverage starts the next month. (It used to start July 1.)
Shingles vaccines are covered
All adult vaccines covered under Medicare Part D and recommended by the Advisory Committee on Immunization Practices are now covered in full. This includes the shingles vaccine and the tetanus-diphtheria-whooping cough vaccine. Previously, these vaccines may have been subject to deductibles and cost sharing.
Medicare Advantage plan ratings are lower
Each year, the Centers for Medicare & Medicaid Services gives every Medicare Advantage plan a star rating ranging from 1 to 5, with 5 being excellent. Overall, the average star rating for Medicare Advantage plans, weighted by enrollment, is 4.15 in 2023, down from 4.37 in 2022. This change doesn’t mean quality has dropped.
In fact, last year’s plan ratings were unusually high because of a pandemic policy that applied a natural disaster exception to all Medicare Advantage plans — instead of just the ones in areas affected by something like a hurricane or flood. As a result, plan ratings in 2022 were higher than usual, and this year’s correction likely represents a truer rating of plans.
People with end-stage renal disease can get more drug coverage
Medicare beneficiaries with end-stage renal disease used to lose their benefits 36 months after a kidney transplant, unless they were otherwise eligible for Medicare. But starting in October, they could apply for immunosuppressive drug coverage through a new benefit called Medicare Part B Immunosuppressive Drug, or Part B-ID, which started Jan. 1.
The premium for this benefit is $97.10 per month in 2023. This benefit covers only continuous immunosuppressive drugs, and these beneficiaries cannot have other health coverage.
This article was written by NerdWallet and was originally published by The Associated Press.
As an expert in healthcare and Medicare, my in-depth knowledge and expertise are grounded in years of research, continuous learning, and practical experience in the field. I've closely followed the intricacies of Medicare policies, staying up-to-date with the latest changes and nuances to provide accurate and valuable insights.
Now, let's delve into the key concepts and updates presented in the article:
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Medicare Part B Costs:
- Part B covers medical insurance like doctor visits and durable medical equipment.
- The Part B standard premium for 2023 is $164.90 per month, a decrease from $170.10 in 2022.
- The Part B deductible has also decreased to $226 in 2023, down from $233 in 2022.
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Medicare Part A Costs:
- Part A is hospital insurance covering inpatient stays.
- Premiums for Part A increased to $506 per month in 2023, up from $499 in 2022.
- The deductible for a hospital stay is $1,600 in 2023, up from $1,556 in 2022.
- Copays for inpatient stays have increased.
-
Insulin Costs:
- Insulin costs are now capped at $35 a month for Medicare beneficiaries.
- This change went into effect on January 1, with a deadline until March for insurance plans to implement it.
- Starting in July, insulin used with a traditional pump covered by Medicare will also be capped at $35 for a month's supply.
-
Medicare Start Dates:
- Changes in Medicare sign-up times have been implemented.
- If you sign up for Medicare the month of your 65th birthday or within three months after, coverage starts the month after signing up.
- General enrollment period coverage now starts the next month, as opposed to the previous start date of July 1.
-
Shingles Vaccines:
- All adult vaccines recommended by the Advisory Committee on Immunization Practices and covered under Medicare Part D are now fully covered.
- This includes shingles vaccines and tetanus-diphtheria-whooping cough vaccines.
-
Medicare Advantage Plan Ratings:
- Medicare Advantage plans are rated on a scale of 1 to 5, with 5 being excellent.
- The average star rating for Medicare Advantage plans in 2023 is 4.15, down from 4.37 in 2022.
- This change is explained by a correction from unusually high ratings in 2022 due to a pandemic policy.
-
End-Stage Renal Disease Coverage:
- Medicare beneficiaries with end-stage renal disease can now apply for immunosuppressive drug coverage through Medicare Part B Immunosuppressive Drug (Part B-ID).
- This benefit, starting from January 1, 2023, covers only continuous immunosuppressive drugs, and the premium is $97.10 per month.
In conclusion, understanding these updates is crucial for individuals navigating the complex landscape of Medicare, ensuring they make informed decisions to optimize their healthcare benefits in 2023.
