HealthWhat’s New in Medicare for 2023?

What’s New in Medicare for 2023?

One of the unsettling things that creeps up around the end of the year is wondering what changes could take place in Medicare. The questions weighing on everyone’s minds are whether there will be changes in the various parts of the program, prescription drugs, or anything else.

In 2023, the changes are a bit of a mixed bag. Some costs have increased, and others have decreased. The federal government made tweaks in other areas. Here is a look at what 2023 brings with Medicare. 

Start Dates for New Enrollees

An enrollment change will benefit new enrollees. In past years, Medicare coverage started several months after a person enrolled depending on when they enrolled. In 2023, the coverage starts on the first of the month after you sign up for coverage when you enroll during the general enrollment period that takes place from January 1st to March 31st. In past years, coverage would not have started until July 1st. 

Additionally, changes were made to the Initial Enrollment Period window. Before the coverage was delayed if you enroll in the 3 months after your birthday month. For example, if your birthday is in June and you enroll in July, your coverage will begin on August 1st. 

Part A Changes

For people who do not have to pay for Part A coverage (hospitalization), nothing changes in 2023. For those who must pay to receive coverage, the premium will increase from $499 to $506 per month. The deductible for Part A is also slightly higher in 2023. It increases from $1,556 in 2022 to $1,600 in 2023. 

Medicare beneficiaries can also expect to pay higher copays in 2023. In-patient hospital stays and nursing facility fees will be as follows:

61-90 days in the hospital – $400 per day (was $389 in 2022)

After 90 days in the hospital – $800 per lifetime reserve days, up to 60 days in your lifetime (was $778 in 2022)

21-100 days in a skilled nursing facility – $200 per day (was $194.50 in 2022)

However, keep in mind a Medigap plan will help cover these costs for you. You can learn more about Medigap plans at https://boomerbenefits.com/faq/what-is-medigap/

Part B Changes

Everyone must pay a premium for Medicare Part B which is for physician services and durable medical equipment. Fortunately, the Part B premium goes down in 2023 and so does the deductible. 

Premiums for Medicare Part B in 2022 were $170.10 per month and that drops to $164.90 in 2023. There is one exception to these premiums. Those with higher incomes may have to pay more. 

As far as changes in the Part B deductible, it was $233 in 2022 and it drops to $226 in 2023.  

Changes with Treatments

In addition to changing premiums and deductibles, Medicare is changing what they cover for certain treatments such as treatments for diabetes and end-stage renal disease. There is also a good change regarding a vaccine in 2023. 

Insulin

The cost of insulin for diabetics varied significantly in 2022. Many beneficiaries had difficulty paying for their medication. In 2023, insulin will cost no more than $35 per month and no deductible applies. 

While the change became effective on January 1st, insurers have until March to change the rates. Anyone who overpaid in January or February of 2023, can request a refund from their insurance company. 

There’s good news for diabetics 2023. As of July 1st, the cap is $35 for a month’s supply of insulin that is used with a traditional pump.

Shingles Vaccines

The Medicare plan has also made changes to how they bill for vaccines. The plan will pay for all adult vaccines that the Advisory Committee on Immunization Practices recommends. In 2023, adults can get the tetanus-diphtheria-whooping cough vaccine and the shingles vaccine at no charge. Unlike the plan in 2022, beneficiaries won’t have to pay a copay or coinsurance fee, and the deductible does not apply. 

End-Stage Renal Disease (ESRD)

In 2022, beneficiaries would lose their ESRD benefits after 36 months if they had a kidney transplant (unless they had Medicare for a reason other than ESRD). 

As of October 1, 2032, beneficiaries will be able to apply for immunosuppressive drugs through a new program called Medicare Part B Immunosuppressive Drug or Part B-ID which has already effective (started January 1, 2023). 

The premium for this benefit is $97.10 per month in 2023. To qualify for this benefit, beneficiaries cannot have other health coverage, and it only covers continuous immunosuppressive drugs, 

Beneficiaries can expect to pay $97.10 per month for Part B coverage in 2023. Be aware that this only applies to beneficiaries who don’t have other health insurance plans and the plan only covers continuous immunosuppressive drugs. 

Overall Improvement in Medicare Benefits in 2023

When taken as a whole, the changes in Medicare benefits for 2023 are quite positive. Premiums will largely be favorable. There are many positives for people living with diabetes and end-stage kidney disease. 

Any changes that may be coming in 2024 will be based on how much the federal government pays out this year, and that remains to be seen.

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