As the 2023 Medicare Annual Enrollment Period approaches, you need to know about a number of changes that will affect what you pay for your coverage.
First off, if you are enrolled in a Medicare Advantage plan and/or a prescription drug plan, you should have already received your Annual Notice of Change, updating you on any changes to the plan you are currently in. You should review this notice carefully before deciding if it’s time to perhaps change plans.
Besides that, every year, new premiums are set for Medicare. Here’s what you can expect:
Part B
Part B premiums have been increasing at a steady clip, reaching $170.10 this year. Overall inflation, escalating health care costs, new medical technologies and more people accessing medical services contribute to the increasing premium.
You may be in for a surprise for 2023 after premiums grew rapidly for 2022 due to the anticipated cost of the new Alzheimer’s drug, Aduhelm. The drug was originally priced at over $56,000 but ended up costing around $26,000. Also, the Centers for Medicare and Medicaid Services decided to approve coverage of the drug only for people involved in clinical trials, meaning very few Medicare recipients would qualify to be reimbursed.
The means the CMS overshot on 2022 Part B premiums by about $10 per month. The agency considered refunding the difference, but because of its operating regulations it is not authorized to refund premiums.
So instead, the CMS plans to reflect the savings in the 2023 Part B premium. It has not yet released the premium for 2023, but pundits expect it will be $169.90 — 20 cents less than 2022.
One side note: Beginning this October, individuals with end-stage renal disease, and who do not have other health insurance, can enroll in Part B for immunosuppressive drugs beyond the three-year post-transplant period.
Part C — Medicare Advantage plans
Medicare Advantage enrollment has continued to grow in 2022, with 48% of eligible Medicare beneficiaries enrolled in such plans, according to an analysis from the Kaiser Family Foundation. Those numbers are expected to exceed 50% in 2023 as these plans grow in popularity.
Medicare Advantage plan growth has been fueled by low premiums and ancillary benefits that are not available under traditional Medicare. Also, the avalanche of TV advertising — most of which includes misleading promises of all types of benefits — has funneled more people into these plans.
But one thing is certain: Medicare Advantage plans overall continue to get better and better, and that trend will continue next year. Based on previews provided to insurance agents prior to October release dates, many plans will be:
- Reducing their out-of-pocket maximums,
- Decreasing key copays, and
- Enhancing ancillary benefits.
Part D – Prescription drug plans
Part D premiums are expected to fall 1.8%. The average national price for a drug plan in 2022 is $32.08 per month. It is anticipated to drop to $31.50 for next year.
While the premium has fallen, the Part D deductible will increase to $505 from $480. The initial phase threshold, the amount that when exceeded leads into the “Donut Hole,” will rise from $4,440 to $4,660.
If you rely on certain medications, you should check your plan’s coverage for yours. Drug plans will move some prescriptions to new coverage tiers for the following year, and sometimes they’ll stop covering certain medications that have generic alternatives.
A final word
If you’ve received your Annual Notice of Change and your plan will be changing, call us (720-985-1213) to review your current Medicare Advantage or Part D plan. We can help you decide whether the plan you’re in is still the best one for your life circumstances or if we should shop around for alternatives.
