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What You Need to Know About Medicare 2023

Your coverage will begin on the first of the month after your enrollment in Medicare beginning January 1, 2023, if you enroll in the program the month you turn 65, during the final three months of your initial enrollment period, or during the general enrollment period. In addition, people eligible for Medicare can check out the 2023 alternatives for coverage between regular Medicare, Medicare Advantage, and part D prescription Drug Plans for this period.

While Part B and Medicare Advantage will have reduced pricing in 2023, Medicare Part A will cost slightly more.

Other changes include:

  • Free immunizations, covered by Medicare Part D.
  • Cost caps on specific insulin products for all Medicare Part C and Part D plans.
  • A new Part B benefit that extends coverage for anti-rejection medications following a kidney transplant.

Medicare beneficiaries should check their coverage options each year and choose the ones that best meet their needs because the costs and benefits of Medicare health and prescription plans may change yearly.

 

Program for Medicare Savings (MSP)

Low-income seniors and individuals with disabilities may be eligible for financial support from the Medicare Savings Programs to aid with Medicare costs (MSPs). Yet, even while the MSPs assist a large percentage of the American population in obtaining premium-quality healthcare for a lower price, only roughly half of those who qualify are registered.

The MSPs may cover Medicare coinsurance, deductibles, and copayments for those who qualify for the eligibility requirements. By signing up for an MSP, you can avoid paying Medicare charges and use your money for other essentials like food, shelter, or transportation.

 

Medicare Amendments

However, some of this information, such as the strategies of individual insurers, has yet to be made public.

  • The new Part B cost will be $164.90, a $5.20 reduction from the current monthly standard.
  • Medicare Part B premium decreased from $170.10
  • The deductible for Part B will also be less. It will be $226, down $7.00 from the $233.00 figure for 2022.

The deductible for Medicare Part A (hospital insurance), which usually kicks in when you are admitted to the hospital, will be $1600 in 2023. That represents an increase of $44 from the 2022 costs of $1556. That is valid for the initial 60 days of in-patient treatment.

As you are aware, the charges to you increase the longer you are in-patient. The length of these hospital stays is also extended; the coinsurance for the 61st to the 90th day of in-patient care will be $400/day, an increase of $12 above the $389 coinsurance from 2022.

The cost of lifetime reserve days will rise from $788 to $800 per day starting in 2022.

 

Medicare Advantage 2023

The private plan alternative to regular Medicare, known as Medicare Advantage, has grown in importance within the Medicare program over the past ten years. As a result, nearly half of all Medicare beneficiaries—more than 28 million—will be enrolled in a Medicare Advantage plan in 2022.

 

Plan Offerings in 2023

Number of Plans

The average Medicare beneficiary will have 43 Medicare Advantage plans to pick from in 2023, the most available alternatives. That is more than double the average number of plans available in 2018. These figures don’t include group plans sponsored by employers or unions, as well as Special Needs Plans (SNPs), Medicare-Medicaid plans (MMPs), cost plans, and PACE plans, which are exclusively available to specific groups.

Thirty-five of the forty-three Medicare Advantage plans that will offer prescription drug coverage to the typical Medicare recipient in 2023 are available for individual enrollment (MA-PDs).

Total Number of Plans. In total, 3,998 Medicare Advantage plans are available throughout the country for individual enrollment in 2023 – a 6 percent increase in the number of plans (228 more plans).

The two companies with the most significant number of Medicare Advantage enrollees in 2022, United Healthcare and Humana, have extensive national footprints and provide plans in most counties.

In 2023, Humana offers plans in 89 percent of counties, and United Healthcare offers plans in 84 percent of counties. That’s approximately the same as in 2022.

Eight new companies will enter the market in 2023, contributing to roughly 6% of the increase in general enrollment plans and about 5% in SNPs. Five new competitors offer SNPs. Two companies provide D-SNPs for individuals who are simultaneously eligible for Medicaid and Medicare, two companies provide C-SNPs for people with certain chronic conditions, and one company offers I-SNPs.

Medicare Advantage plans can use rebate funds (including bonus payments) to help pay for additional benefits that are not included in regular Medicare. Therefore, we consider them to be “primarily health-related.” As of January 2019, CMS’s definition of “primarily health-related” changed and included the provision of supplemental benefits by Medicare Advantage plans.

 

What’s More?

Additionally, Medicare Advantage plans may limit access to these benefits to specific beneficiary categories, such as those with diabetes or congestive heart failure, so that various benefits are accessible to different members.

Individual plans will include at least 97% coverage for telehealth, fitness, vision, dentistry, and hearing in 2023. Although these benefits are broadly accessible, there are differences in the level of coverage for these services. For instance, a dental benefit could include cleanings and preventative treatment or a more extensive range.

The extent to which participants may receive supplemental benefits is unclear because plans sometimes publish information regarding the usage of these benefits or related expenses.

The Social Security COLA is 8.7% for 2023, the highest level in decades. Furthermore, the Part B premium is falling in 2023 as opposed to 2022, when a portion of senior citizens’ COLA had to be utilized to fund the higher Part B premiums. Therefore, retirees will have full access to the COLA to apply toward other living expenses, which have grown significantly in 2022.

Medicare beneficiaries may also be able to reduce their vaccination costs. Beginning January 1, 2023, individuals who have Medicare prescription drug coverage will have access to all adult vaccines covered by Part D and advised by ACIP (Advisory Committee on Immunization Practices), including the Tetanus-Diphtheria-Whooping Cough and shingles vaccines.

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