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What you need to know about Medicare changes for 2023

Some rate cuts, some deductible increases, and a cap on the price of insulin are some of the changes

WASHINGTON D.C., DC — Several Medicare changes are on the horizon for 2023 due to the Cost of Living Adjustment (COLA) and the Inflation Reduction Act. The Social Security COLA for 2023 is 8.7%, the highest in decades.

Approximately 70 million Social Security and Supplemental Security Income recipients are subject to the COLA. The adjustment is based on the CPI-W, or Consumer Price Index for Urban Wage Earners and Clerical Workers.

Premiums and Deductibles for Plan B

A decrease in the Part B premium begins in 2023. Seniors will have access to the entire COLA adjustment to help offset the significant rise in their cost of living and will not have to spend their newly gained extra money on Medicare.

Medicare recipients will experience a cut in their rates for the first time in almost a decade. In 2023, the regular monthly price for those with Medicare Part B coverage will decrease by $5.20 to $164.90. Following a record 14.5% hike in 2022, rates rose from $148.50 to $170.10, the highest amount ever.

As Medicare Part B spending in 2022 came in lower than anticipated, a surplus was created, which is being used to lower premiums for enrollees in 2023. Savings were made possible because Aduhelm, a medication used to treat Alzheimer's, cost less than anticipated.

In addition, the Part B deductible will decrease for the first time since 2012 from $233 in 2022 to $226 in 2023.

Inpatient care, outpatient care, home health services, durable medical equipment, and other medical services are some of the medically necessary services that Part B covers. A few preventive services are also covered in Part B. The cost reduction of Medicare Part B benefits many Social Security recipients.

Medicare Part A Premiums Increase

Medicare Part A is free for most beneficiaries and includes inpatient hospital care. Currently, the deductibles sit at $1,556. But this increases by $44 for 2023, bringing the total to $1,600. It is applicable for the first sixty days of hospitalization.

The amount of co-insurance has also increased beyond the initial 60 days. From the 61st day through the 90th day, CMS estimates that consumers will pay $400 daily in co-insurance in 2023, up from $389 in 2022.

A small discount for Medicare Part D premiums in 2023 brings the price down from $32.08 to $31.50. Those who take insulin reap one of the most significant benefits. Due to the Inflation Reduction Act, the cost of a month's insulin supply reduces to $35. Medicare recipients will not incur any charges for receiving immunizations deemed necessary by the Advisory Committee on Immunization Practices.

There will be no out-of-pocket expenses when it comes to Medicare Part D-covered adult vaccines. Vaccines under Medicare Part D can be obtained at no cost to the patient.

Medicare Part C (Advantage Plans)

Medicare's Parts A, B, and D are rolled into this package. Part C, provided by private companies, offers a broader range of benefits than traditional Medicare, though these may vary from provider to provider. Benefits can range from transportation to regular dental and vision exams and Part D coverage.

Next year, Health and Human Services (HHS) anticipate enrolling 31,8 million individuals. The average cost of an Advantage Plan in 2023, in addition to the cost of Medicare Parts B and D, is $18.00, a decrease from $19.52 the previous year. Some Advantage Plans provide this benefit free of charge if you have Part B through their company.

Rebates for Plan B and D Drugs

Manufacturers of Medicare-covered prescription drugs will be required to begin sending rebates to the program in 2023 if their prices increase faster than the rate of inflation. The Centers for Medicare and Medicaid Services will measure the price increases of Part D drugs for each rebate year, which began on October 1.

Pharmaceutical manufacturers are required to pay within 30 days of receiving an invoice. Similarly, Medicare Part B drugs (those used in medical facilities or private practices) will have their price increase tracked quarterly beginning in January 2023. It is expected that prescription drugs your insurance covers may see slower price increases.

The Kaiser Family Foundation reported in February 2022 that for roughly half of all Medicare-covered drugs, price increases in 2020 were higher than inflation. Any future increases in that amount would be limited to the inflation rate under the new law.

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