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2023 Medicare Changes You Need to Know

We know our Medicare Plans Better than anyone. Here’s the important news about 2023 Medicare plan.

2023 Medicare Changes Summary

Starting January 1st, 2023:

  • The standard Part B Premium is $164.90/month down from $170.10/month in 2022
  • Medicare Part B deductible decreased to $226 per year
  • Medicare Part A premiums, (if applicable) deductible, and coinsurance are higher in 2023.
  • The income brackets for high – Income premium adjustments for Medicare Changes in Part B and D have been adjusted for inflation. In 2023, “High – Income” starts at $97,000 for a single person, instead of $91,000.
  • Part D coverage gap (commonly known as the donut hole) is more affordable. As in 2022, once you enter the coverage gap the cost for your plan is covered. Brand name and generic drugs will be no more than a 25% coinsurance payment. Some people never reach the coverage gap, as the threshold is $4,660.
 

2023 Medicare Part A Changes

Starting January 1st, 2023:

  • Medicare Part A inpatient deductible for hospital admittance has increased from $1,556 (in 2022) to $1,600 (in 2023) for each benefit period.
  • The Medicare Part A premium for people with 30+ (but less than 40) quarters of work history, has increased from $274/month (in 2022) to $278/month (in 2023).
  • The Medicare Part A premium for people with fewer than 30 quarters of work history, is increasing from $499/month (in 2022) to $506/month (in 2023).
 

PART A:  HOSPITALIZATION INPATIENT DEDUCTIBLE AND COINSURANCE

 

  • Part A has a deductible that applies to each benefit period (rather than a calendar year deductible like Part B or private insurance plans) and is increasing from $1,556 (in 2022) to $1,600 (in 2023)*. *This increase applies to all enrollees, although many enrollees have Medicare Supplement (Medigap) Insurance coverage that pays all or part of the Part A deductible.
  • Days 1-60: $0 coinsurance for each benefit period.
  • Days 61-90: $400 coinsurance per day of each benefit period.
  • Days 91 and beyond: The coinsurance per each “lifetime reserve day” after day 90 for each benefit period is $800 coinsurance per day in 2023 (up from $778 per day in 2022). (up to 60 days over your lifetime)
  • In 2023, the recipient will pay all costs beyond lifetime reserve days.
 
PART A: SKILLED NURSING FACILITIES

  • Medicare only covers skilled nursing facility care if the patient had an inpatient hospital stay of at least three days before being transferred to a skilled nursing facility. There is a coinsurance payment that applies to days 21 through 100 in a skilled nursing facility, and for days 101 and beyond, all costs must be paid by the recipient.
  • Days 1-20: $0 for each benefit period
  • Days 21-100: $200.00 (up from $194.50 a day in 2022) coinsurance per day of each benefit period.
  • Days 101 and beyond: all costs must be paid by the recipient.

2023 Medicare Part B Changes

Starting January 1st, 2023:

  • The standard monthly premium of Medicare Part B decreased to $164.90/month in 2023. (Down from $170.10 in 2022).
  • The annual deductible for Medicare Part B is $226 per year in 2023. (down from $233 in 2022)
  • Most people pay the standard monthly premium amount ($164.90).  If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay an Income Related Monthly Adjustment Amount. The Income Related Monthly Adjustment Amount (IRMAA) brackets have been changed as follows.

2023 Medicare Part D Changes

Starting January 1st, 2023:

  • The Part D monthly premium varies by plan.
  • For stand-alone Part D prescription drug plans, average basic premiums is a projected average premium of $31.50/month.*
 

*It is important to understand that the average basic premium is less than the average enhanced plan premium, so overall average Part D premiums are higher than the average basic premiums.

 

  • Most Medicare drug plans have a coverage gap (also called the “donut hole”).  This means there is a temporary limit on what the drug plan will cover for drugs.  Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount on covered drugs
  • In 2022, the coverage gap applied after an initial amount of $4,430 was spent. In 2023, the coverage gap applies after an initial amount of $4,660 is spent.  The good news is that the Affordable Care Act (ACA) has been gradually closing the coverage gap in Medicare Part D.  The percentage is set by Medicare. In 2019, once the coverage gap started, Medicare members paid 25% for brand-name prescriptions and 37% for generic medications.  Now, in 2023, once the coverage gap starts, Medicare members only have to pay 25% for both brand-name and generic prescriptions. 

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