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By: Kate Ashford of NerdWallet
A new year means changes to Medicare, including updated premiums and deductibles and sometimes big policy moves. In 2023, there’s a little of everything: Some costs have gone down, others have increased, and there are some notable tweaks to how Medicare works.
Understanding what’s new can help you get the most from your Medicare benefits. Here are some key 2023 updates, according to the Centers for Medicare & Medicaid Services.
PART B COSTS HAVE GONE DOWN
Medicare Part B is medical insurance that covers needs like doctor visits and durable medical equipment, such as wheelchairs and walkers . Everyone pays a Part B monthly premium , even people with Medicare Advantage plans.
In 2023, the Part B standard premium is $164.90 per month, down from $170.10 per month in 2022. If you have a higher income, you may pay more . The Part B deductible dropped to $226 in 2023, down from $233 in 2022.
PART A COSTS HAVE GONE UP
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 increased to $506 per month, up from $499 in 2022. And the deductible for a hospital stay is $1,600 in 2023 for each benefit period, up from $1,556 in 2022.
Copays for inpatient stays in hospitals and skilled nursing facilities are also up. These are costs per benefit period:
— $400 per day for days 61 to 90 in a hospital (up from $389).
— $800 per “lifetime reserve day” after day 90 in a hospital, up to a limit of 60 days in your lifetime (up from $778).
— $200 per day for days 21 to 100 in a skilled nursing facility (up from $194.50).
What you’ll pay for Medicare Part C (Medicare Advantage)
Medicare Advantage is a bundled alternative to Original Medicare that includes the benefits of Part A, Part B and usually Part D. These plans often include additional benefits, such as some coverage for dental or vision care. They’re sold by private health insurance companies, and premiums vary.
Although the average monthly premium for a Medicare Advantage plan is $18 in 2023, many available plans have a $0 premium. You’ll pay your Medicare Advantage premium in addition to your Part B premium (and Part A, if you’re not premium-free). That said, some plans will pay part or all of your Part B premiums.
In addition to the monthly premium, Medicare Advantage plans may come with deductibles, copays or coinsurance. Look through each plan’s fine print to understand what kind of charges you’ll pay for medical services.
What you’ll pay for Medicare Part D
Medicare Part D is prescription drug coverage, and it’s sold by private health insurance companies, so premiums vary by policy. In 2023, the average Part D plan premium is $31.50 per month, but drug plan prices range from $1.60 to $201.10 per month.
Like Part B, you’ll pay more for your Part D coverage if you have a higher income. The same thresholds apply: If your 2021 income was more than $97,000 (filing individually) or $194,000 (filing jointly), you’ll pay an additional $12.20 to $76.40 per month, on top of your Part D premium.
There’s also a deductible for some (but not all) Part D plans, which in 2023 can be no higher than $505.
What you’ll pay for Medigap
If you stick with Original Medicare (instead of Medicare Advantage), you have the option of purchasing additional coverage in the form of a Medigap plan, or Medicare Supplement Insurance. These plans are offered by private insurers and pay many of the costs and deductibles of Part A and Part B, and they may offer some health coverage if you travel internationally. You can’t have both a Medigap and a Medicare Advantage plan at the same time.
Medigap premiums vary by plan and location. The best time to buy a Medigap policy is during the six-month window that starts the first month you have Medicare Part B (and you’re 65 or older). During this time, Medigap companies must offer you a plan at the same price as everyone else, regardless of your health status. After that, companies may raise the price or not offer you a plan, depending on your health situation.
INSULIN COSTS ARE CAPPED
New this year, insulin costs are limited to $35 a month for Medicare beneficiaries, and there is no deductible. Although the change went into effect Jan. 1, plans have a deadline of March to put this system in place. If you pay more than $35 a month for insulin in January and/or February, ask your plan about reimbursement for the overage.
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 SHIFTED
It used to be that for certain Medicare sign-up times, your coverage started two to three months later, which could cause gaps in health care. Starting this year, those dates have changed.
If you sign up for Medicare the month of your 65th birthday or during the three months after, your coverage now starts the month after you sign up . Similarly, if you sign up for Medicare during the general enrollment period from Jan. 1 to March 31 each year, your coverage starts the next month. (It used to start July 1.)
SHINGLES VACCINES ARE COVERED
All adult vaccines covered under Medicare Part D and recommended by the Advisory Committee on Immunization Practices are now covered in full. This includes the shingles vaccine and the tetanus-diphtheria-whooping cough vaccine. Previously, these vaccines may have been subject to deductibles and cost sharing.
MEDICARE ADVANTAGE PLAN RATINGS ARE LOWER
Each year, the Centers for Medicare & Medicaid Services gives every Medicare Advantage plan a star rating ranging from 1 to 5, with 5 being excellent. Overall, the average star rating for Medicare Advantage plans, weighted by enrollment, is 4.15 in 2023, down from 4.37 in 2022 . This change doesn’t mean quality has dropped.
In fact, last year’s plan ratings were unusually high because of a pandemic policy that applied a natural disaster exception to all Medicare Advantage plans — instead of just the ones in areas affected 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 rating of plans.
(AP)
This article was provided to The Associated Press by the personal finance site NerdWallet. Kate Ashford is a writer at NerdWallet. Email: [email protected]. Twitter: @kateashford.
