The Centers for Medicare & Medicaid Services (CMS) update Medicare rate and benefit changes annually. CMS recently announced changes to Premiums, Deductible and Cost sharing for the 2023 year. We’ve summarized the main changes below.
Medicare Part B Premiums
The standard monthly premium for Medicare Part B enrollees is decreasing from $170.10 in 2022 to $164.90 in 2023. Rate reductions are rare, so this is a welcome surprise.
Medicare Part B Income-Related Monthly Adjustment Amounts known as IRMAA
If your income is over certain thresholds, Medicare charges an additional premium called “IRMAA” for Part B and Part D. “IRMAA” stands for Income Related Monthly Adjustment Amounts. These change from year to year. Below are the IRMAA amounts for 2023.
Medicare Part D Income-Related Monthly Adjustment Amounts (IRMAA)
Individuals with higher incomes pay an Income-Related Monthly Adjustment Amount in addition to their Part D premium.
Part A Premium
Medicare Part A is known as “hospital insurance” and covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some healthcare services. For 99% of Medicare beneficiaries, Part A is premium-free because they have at least 40-quarters of Medicare covered employment. For those that don’t qualify, Part A can be purchased for a monthly premium of $506 in 2023. For certain individuals who qualify, a reduced Part A premium of $278 will apply.
Part A Deductible
The Medicare Part A deductible for inpatient hospital services will be $1,600 in 2023, a
$44 increase from 2022 ($1,556). This Part A deductible covers beneficiaries share of costs for the first 60 days of a Medicare covered inpatient hospital stay in a benefit period. A benefit period begins when you enter the hospital and ends when you are out for 60 days in a row. One benefit period may include more than one hospitalization.
For days 61-90 of hospitalization, beneficiaries must pay a coinsurance amount of $400 per day in 2023 (up from $389 in 2022). Original Medicare covers up to 90 days of inpatient hospital care each benefit period. You also have an additional 60 days of coverage, called “lifetime reserve days”. These 60 days can be used only once, and you will pay a coinsurance for each one at $800 per day in 2023 (up from $778 per day in 2022). Keep in mind that many Medicare insurance plans cover this deductible and/or help pay inpatient hospital copays.
Skilled Nursing Facility Coinsurance
For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21-100 of extended care services in a benefit period is increasing from $200 in 2023 (up from $194.50 in 2022). Coinsurance for days 1-20 is $0 per day. Many Medicare insurance plans help cover these coinsurance costs.
Part B Deductible
The annual Part B deductible is decreasing in 2023, down to $226 (from $233 in 2022).
Medicare Enrollment Timeline Changes
Beginning January 1, 2023, when you enroll in Medicare during your Initial Enrollment Period (IEP), there are a few important changes to the enrollment timelines that are beneficial for Medicare enrollees.
If you enroll in Medicare during the 3 months before your 65th birth month, your coverage will start the 1st of the month you turn 65. If you enroll during your 65th birthday month, your coverage will begin the 1st of the next month. If you enroll in the 3 months following your birthday month, your coverage will begin the 1st of the next month. Previously, if you enrolled in the 3 months following your birth month, or in the General Enrollment Period (GEP), the Medicare effective date could be delayed from 1-6 months.
New Special Enrollment Circumstances
Beginning in 2023, you may be able to sign up for Medicare through a Special Enrollment Period (SEP) if you miss an enrollment period because of certain exception circumstances, like being impacted by a natural disaster or an emergency, incarceration, or losing Medicaid coverage. Medicare has the ability to offer a special exception if you missed your enrollment window for a good reason. You’ll need to contact Medicare directly to request a special enrollment exception. For more information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TYY users can call 1-877-486-2048.
Kidney transplants & immunosuppressive drug coverage Medicare will offer a new benefit that helps continue to pay for immunosuppressive drugs beyond 36 months after a kidney transplant (if you don’t have other health coverage).