What’s new for Medicare in 2023?

(NerdWallet) – A new year means changes to Medicare, including updated premiums and deductibles and sometimes big political moves. There’s a little bit of everything in 2023: Some costs are down, others are up, and there are some significant changes to the way Medicare works.

Understanding what’s new can help you get the most out of your Medicare benefits. Here are some key updates for 2023, according to the Centers for Medicare & Medicaid Services.

Part B costs have been reduced

Medicare Part B is medical insurance that covers necessities such as doctor visits and permanent medical equipment, such as wheelchairs and walkers. Everyone pays a monthly Part B premium, even people with Medicare Advantage plans.

In 2023, the standard Part B premium is $164.90 a month, down from $170.10 a month in 2022. If you have a higher income, you may pay more. The Part B deductible drops to $226 in 2023, from $233 in 2022.

Part A costs have increased

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 have increased to $506 a month, up from $499 in 2022. And the hospital deductible is $1,600 in 2023 for each benefit period, up from to $1,556 in 2022.

Cost increases for inpatient hospital stays and skilled nursing care also increased. These are the costs per benefit period:

  • $400 per day for hospital days 61-90 (up from $389).
  • $800 per “lifetime reserve day” after the 90th day in the hospital, up to a limit of 60 days in your life (from $778).
  • $200 per day from day 21 to day 100 in a skilled nursing facility (from $194.50).

Insulin costs are limited

New this year, insulin costs are capped at $35 per month for Medicare beneficiaries and there is no deductible. Although the change came into effect on January 1, the deadline for setting up this system is planned for March. If you pay more than $35 a month for insulin in January and/or February, ask your plan about reimbursement.

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 moved

It used to be that for certain Medicare enrollment times, your coverage would start two to three months later, which could cause gaps in health care coverage. As of this year, those dates have been changed.

If you sign up for Medicare in the month of your 65th birthday or during the three months after that, your coverage now starts one month after you sign up. Similarly, if you sign up for Medicare during the general enrollment period from January 1 to March 31 each year, your coverage begins the following month. (It started on July 1.)

Shingles vaccines are covered

All vaccines for adults covered by Medicare Part D and recommended by the Advisory Committee on Immunization Practices are now fully covered. This includes the shingles vaccine and the tetanus-diphtheria-whooping cough vaccine. Previously, these vaccines could be subject to deductibles and cost-sharing.

Medicare Advantage plan ratings are lower

Each year, the Centers for Medicare & Medicaid Services gives each Medicare Advantage plan a star rating ranging from 1 to 5, with 5 being excellent. All in all, the average star rating for Medicare Advantage plansweighted by enrollment, it is 4.15 in 2023, down from 4.37 in 2022. This change does not mean that quality has declined.

In fact, last year’s plans’ ratings were unusually high because of a pandemic policy that applied the natural disaster exception to all Medicare Advantage plans — instead of just those in areas hit 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 plan rating.

People with end-stage kidney disease can get more drug coverage

Medicare beneficiaries with end-stage renal disease lost their benefits 36 months after a kidney transplant, unless they were otherwise eligible for Medicare. But starting in October, they could sign up for coverage of immunosuppressant drugs through a new benefit called Medicare Part B Immunosuppressant 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 insurance.

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