2023 Medicare Changes Seniors Should Know About

Many seniors rely on Medicare, the national health insurance program run by the federal government, to cover their medical needs and health care expenses. Every year, the government evaluates the Medicare program and reveals the adjustments they deem necessary for the upcoming year, such as for 2023.

Medicare is an expansive government program, taking care of almost one-fifth of American citizens - that's over 61 million people! It provides health insurance for those aged 65 and above, but only for U.S. citizens and legal permanent residents who have been living in the country for at least five years.

Breaking it down, there are four primary components of Medicare coverage that we'll discuss in the following section.

Often referred to as hospital insurance, Medicare helps cover the costs associated with hospital stays, nursing care, and hospice. Reaching retirement age automatically grants you access to this coverage, and for most people there is no premium payment required. However, there are certain restrictions in place.

Part B: Major medical insurance is the term often used for this type of coverage, which includes things like outpatient care, doctor visits, lab tests, and medical equipment. To get the coverage, you'll need to apply for it and pay a monthly premium plus a deductible.

Original Medicare does not give you coverage for dental and vision care, so the government has authorized private insurance companies to offer Medicare Advantage plans that provide for these services and more, all under the watchful eye of the government.

Part D: Get the extra coverage you need for prescription drugs! Regular Medicare doesn't cover all costs, so we offer additional policies through private insurance companies to make sure you get the protection you need.

Discover the major updates coming to Medicare in 2023! Here's a list of the most important changes you should be aware of.

Part A

The vast majority of enrollees are exempt from paying a premium for Part A coverage, but they are still required to pay the deductible and co-insurance. In 2023, the deductible will be increased to $1,600 (up from $1,556 in 2022). This fee applies to all Part A enrollees and covers the first 60 days of inpatient care within a benefit period. For any additional days beyond that, a daily co-insurance charge of $400 must be paid (up from $389 per day in 2022).

Part A of Medicare will cover the first 20 days of care received in a skilled nursing facility. However, a coinsurance payment of $194.50 per day will apply to days 21 through 100. This amount is set to increase to $200 per day in 2023.

Part B

For the first time since 2012, the monthly premium for Medicare Part B is decreasing in 2023! While everyone still has to pay a premium for this coverage, it will be $164.90/month, which is lower than the 2022 premium of $170.10/month. Plus, the Part B deductible is also decreasing from $233 in 2022 to $226 in 2023.

High-income Medicare beneficiaries will face an increase in their Part B premium costs come 2023. This shift raises the threshold where the surcharge kicks in to $97,000 for a single person, and $194,000 for a married couple, up from the 2022 levels of $91,000 and $184,000 respectively. Those affected by the change could see a premium ranging from $230.80/month to $560.50/month, based on their income.

Medicare Advantage

The private insurance companies determine the cost of premium payments for these plans, but the government has put a limit on the amount of out-of-pocket costs that can be charged. In 2022, the maximum out-of-pocket limit for Medicare Advantage plans was boosted to $7,550 (plus out-of-pocket costs for prescription drugs). And for 2023, that cap is increasing even further - up to $8,300. Fortunately, most Advantage plans will keep their out-of-pocket caps below the government’s maximum.

Part D (Medication)

Beginning in 2023, the standard plan’s maximum deductible will rise to $505 and the threshold for entering the catastrophic coverage phase – where out-of-pocket spending decreases significantly – will be set at $7,400. Fortunately, the Inflation Reduction Act will grant Part D enrollees free coverage for vaccines and access to insulin for just $35/month.

Kidney Transplant Patients

Starting in 2023, Medicare coverage for kidney transplant recipients won't just last for 36 months after the procedure. Instead, those who have received a kidney transplant will have the benefit of limited Part B coverage for immunosuppressive drugs that they must take for the rest of their lives to avoid their body rejecting the new organ. This extended coverage is a major victory for transplant recipients!

Change In Start Dates For New Enrollees

Starting in 2023, if you enroll within the month you turn 65 or within the three months following, your coverage will begin the next month - no longer do you have to wait up to three months after enrollment for your coverage to kick in!