Providing health and financial security to about 63 million people in America, Medicare gives seniors 65 and older access to essential health services including physicians, hospital stays and prescription drugs. Medicare is divided into four parts—Part A through Part D—providing different levels of coverage or benefit. Part A provides inpatient and hospital coverage; Part B provides outpatient and medical coverage; Part C (Medicare Advantage and Medical Supplement) offers a private plan to receive your benefits; Part D provides coverage for prescriptions. Because each part plays an integral role in your health care, it’s crucial to stay informed of changes that may affect you.
In 2023, historical changes to Medicare come from the Inflation Reduction act that limits out-of-pocket drug costs, puts a cap on insulin copays and makes vaccines accessible to seniors. While this will decrease the average monthly cost of a Part D premium, if you’re subjected to pay the maximum deductible, this limit will increase, and your premium-based savings may recede. Below are specific changes that may affect you.
Deductible is $1,600 per benefit period and the coverage lasts from the day you’re admitted through 60 consecutive days after discharge, even if you are readmitted for the same reason.
In 2023, the standard base premium is $164.90 and is based on your modified gross income (MAGI) from your tax returns from two years ago, instead of three. In 2023, your premium will be based on your 202 MAGI. As it is for most of our residents, if your MAGI is less than $97,000 individually or $194,000 jointly, then your Part B premium won’t increase.
The annual deductible for Part B is $226 in 2023. Once satisfied for the year, you will only be responsible for 20% of Part B bills—known as your Part B coinsurance.
Part C plan premiums for Medicare Advantage are determined by the carriers that sell them. However, many plans have a zero-cost premium with a copay or coinsurance for each covered service (e.g., $20 copay for primary care visits or $240 daily copay for hospital stays.)
While insurance carriers set prices for Part D drug costs—ranging from $13-$90 or more—for most, the average Part D plan is $31-$41 a month and based on your previous income. Similar to Part B, most residents won’t have an income-related monthly adjustment amount (IRMAA).
If you are approaching eligibility for Medicare or currently have a plan and need to compare your 2023 coverage options, a licensed insurance agent can help you compare Advantage plans available to you. This includes costs, benefits, network restrictions and more.