The Centers for Medicare and Medicaid Services has released the 2023 premiums, deductibles, and coinsurance amounts for fee-for-service Medicare Part A and Part B, and the 2023 Medicare Part D income-related monthly adjustment amounts.
The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022.
Part B covers physician and outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
The reason for the premium decrease is that the 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm for Alzheimer’s disease. The drug has been controversial due to questions over its benefits, and price.
Lower-than-projected spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance Trust Fund, which can now be used to limit future Part B premium increases.
Medicare Open Enrollment for 2023 will begin on October 15 and ends on December 7. CMS said it would soon release premiums and cost-sharing information for 2023 Medicare Advantage and Part D plans.
INSULIN COST CAPPED
Starting July 1, people with Medicare who take insulin through a pump won’t have to pay a deductible, and cost-sharing will be capped at $35 for a one-month supply of covered insulin. This benefit will be available to people with pumps supplied through the durable medical equipment benefit under Part B.
KIDNEY TRANSPLANT COVERAGE
Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10.
MEDICARE SAVINGS PROGRAMS
To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality healthcare at a reduced cost, yet only about half of eligible people are enrolled, CMS said. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility.
PART B INCOME ADJUSTMENTS
Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7% percent of people with Medicare Part B. The 2023 Part B total premiums are available here.
MEDICARE PART A
Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation and some home healthcare services. About 99% percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.
The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,600 in 2023, an increase of $44 from $1,556 in 2022.
The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2023, beneficiaries must pay a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization ($389 in 2022) in a benefit period and $800 per day for lifetime reserve days ($778 in 2022).
For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200 in 2023, compared to $194.50 in 2022.
Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $278 in 2023, a $4 increase from 2022.
Certain individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlements will pay the full premium, which will be $506 a month in 2023, a $7 increase from 2022.
MEDICARE PART D
Since 2011, higher income beneficiaries’ Part D monthly premiums are based on income. These income-related monthly adjustment amounts affect roughly 8% of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium.
Part D premiums vary from plan to plan and roughly two-thirds of beneficiaries pay premiums directly to the plan, while the remaining beneficiaries have their premiums deducted from their Social Security benefit checks.
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Photo courtesy of: Healthcare Finance
Originally Published On: Healthcare Finance
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