January 2023: What’s New for Medicare in 2023?

 

 

Part A: Hospital insurance

Part A premium

 

Free if you’ve worked 10 years or more

$278 per month if you’ve worked 7.5 to 10 years

$506 per month if you’ve worked fewer than 7.5 years

Part A hospital deductible $1,600 each benefit period
Part A hospital coinsurance

 

$0 for the first 60 days of inpatient care each benefit period

$400 per day for days 61-90 each benefit period

$800 per lifetime reserve day after day 90 in a benefit period (You have 60 lifetime reserve days that can only be used once. They’re not renewable.)

Skilled nursing facility insurance $0 for the first 20 days of inpatient care each benefit period

$200 per day for days 21-100 each benefit period

 

Part B: Medical insurance

Part B premium

(For individuals with incomes below $97,000 or couples with incomes below $194,000)

$164.90 is the standard premium
Part B deductible $226 per year
Part B coinsurance 20% for most services Part B covers

 

National average Part D premium $32.74 per month
Part D maximum deductible $505 per year
Coverage gap begins $4,660
Catastrophic coverage begins $7,400

Part D: Prescription drug coverage

If you have a Medicare Advantage Plan, contact your plan directly for your 2023 premium, copayments, and deductible.

Updates to Medicare prescription drug coverage in 2023

  • All Part D-covered vaccines, including the shingles vaccine, will be $0.
  • All Part D-covered insulin copays will be limited to $35 (starting January 2023).
  • All Part B-covered insulin copays will be limited to $35 (starting July 2023).
  • Part B-ID will be available for extended immunosuppressant coverage. You are eligible if:
    • You qualify for Part B coverage of immunosuppressants prior to losing ESRD Medicare 36 months after your kidney transplant
    • You do not have Medicaid or other health insurance that covers immunosuppressants

Enrollment period changes in 2023

Initial Enrollment Period (IEP): The IEP is a seven-month period including the three months before, the month of, and the three months following your 65th birthday month. Beginning in 2023, coverage begins the first of the following month (but no earlier than the month you are Medicare-eligible). For example, if your 65th birthday is in April 2023:

 

 

 

 

 

General Enrollment Period (GEP): The GEP runs from January 1 through March 31 each year. In the past, your coverage would start on July 1 if you used the GEP. Starting in 2023, your coverage will start the first of the month after you enroll if you use the GEP.

 

Special Enrollment Periods (SEPs): SEPs are periods of time outside normal enrollment periods when you can enroll in Medicare or change your coverage. Beginning in 2023, new SEPs have been created for people who:

  • Lose Medicaid
  • Are in an area with a disaster or emergency
  • Are released from incarceration
  • Make an enrollment mistake based on misinformation from their employer
  • Experience other exceptional circumstances