Medicare Premiums and Deductibles: What Is Changing for 2023

In 2023, we can expect several areas of coverage to increase. Parts A, B, C, and D will all be positively affected. Due to the large change in inflation, specific adjustments will be made to help individuals cover the rising cost of care. Deductions will be based on an individual’s income bracket.

Key takeaways:
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    Medicare costs typically change yearly, considering the economy and any healthcare events that may impact patients or recipients.
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    Open enrollment is available from now until December 7th, 2022.
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    During Open Enrollment, participants can compare different Medicare options, such as prescription medication plans and Medicare Advantage plans.

Medicare costs typically change yearly, considering the economy and any healthcare events that may impact patients or recipients. Often, these include premiums, deductibles, and copayments. If you are a Medicare recipient, it’s crucial to stay on top of your benefits to plan for your healthcare needs and get the appropriate services. Open enrollment opened in October and closes on December 7th, 2022.

Part A

Medicare Part A covers inpatient hospital care, skilled nursing facility (SNF) care, home health care, and hospice care. With inpatient hospital care, you are covered for up to 90 days for each benefit period and have 60 lifetime reserve days. For skilled nursing, room, board, and some services such as tube feeding are covered, but you must have been an inpatient at a hospital within 30 days of admission and require therapy or nursing services. Home care covers up to 100 days of daily care and unlimited intermittent care. Still, it requires three consecutive days of inpatient care at the hospital within the last 14 days of obtaining home health. Keep in mind that not all Medicare beneficiaries have a Part A premium.

Medicare Part A will increase by $44 from 2022 to 2023. An increase in inpatient hospital deductible stays will also occur in 2023, depending on the length of stay. Coinsurance for stays from the 61st-90th hospital stay will change from $389 per day to $400, and lifetime reserve days will change from $778 to $800. For skilled nursing facility coinsurance, the cost will rise to $5.50 for days 21 through 100.

Part B

Medicare Part B coverage includes:

  • Physician services.
  • Outpatient hospital services.
  • Some home health care.
  • Durable medical equipment (like wheelchairs or walkers).

This can also include preventative services, therapies, laboratory testing, ambulance services, and prescription drugs. The Social Security Act determines the rates for Medicare Part B.

In 2023, the monthly premium will change from $170.10 to $164.90. The annual deductible for beneficiaries will decrease by $7 to $226. Part B will also be extended to those who have had a kidney transplant beyond 36 months.

Part C

Medicare Advantage Plans, or Part C, is an HMO or PPO health plan that can supplement your current insurance. These are offered by private companies that have received approval. The plan covers your hospital and medical insurance coverage, or Part A and Part B, and may provide extra coverage. Additional coverage can include vision, hearing, dental, prescription drugs, and more.

In 2023, The average premium for Medicare Part C will decrease to around $1.52 from 2022, for a total of $18 a month. Advantage plans are required to cap out-of-pocket costs for Part A and B services, excluding the cost of prescription drugs. In 2023, the cap will increase to $8,300 from $7,550 in 2022.

Part D

Part D coverage covers your prescription drugs. Part D plans must include more than one drug from a formulary in each category. Categories include antidepressants, antipsychotics, or other kinds of drugs.

In 2023, the prescription drug coverage will increase from $480 to $505. Premiums are expected to be around $31.50 monthly, down from $32.08. The out-of-pocket threshold will also increase from $7,050 to $7,400.

Open Enrollment

Medicare Open Enrollment began in October 2022 and will end on December 7th, 2022. During Open Enrollment, participants can compare different Medicare options, such as prescription medication plans and Medicare Advantage plans. Medicare-eligible adults may also qualify for Medicare Savings Programs (MSP) or financial assistance. These can help cover premiums, deductibles, coinsurance, and co-payment costs. We expect to see more options for telehealth. Many large plans, such as Aetna, Humana, and UnitedHealthcare, plan to expand to several more states with expanded coverage options.

Inflation adjustments

Those who fall into higher income brackets have monthly adjustment amounts for Medicare Part D, meaning they pay the adjustment amount in addition to their premium. Some recipients pay premiums directly to the plan, while others have it deducted from their Social Security checks.

In 2023, surcharges will begin to be added for those who fall within $97,000 as an individual or $194,000 as a couple. In 2022, they were $91,000 for an individual and $194,000 for a couple. This increase is due to inflation and will be based on 2021 income tax returns. High-income beneficiaries will see many different premiums for Part B based on their income. However, it will still be a lower cost than in 2022.

While we know we will see many positive changes in 2023 for Medicare recipients, it’s essential to remain educated about your options. Particularly regarding Plan D coverage or specific procedures, you want to know how to prepare accordingly. To stay up-to-date on costs, coverage, or benefits, regularly check out the CMS website or Medicare.gov. They include physician fee schedules and prospective payment systems. Medicare.gov will allow you to learn the basics before selecting a coverage option.

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