10 Medicare Changes for 2023 You Need to Know

NEWS & TRENDING - RETIREMENT NEWS
Medicare beneficiaries can look forward to lower insulin costs, earlier start dates for new enrollees, and more starting in 2023.
Updated May 1, 2024
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Medicare helps millions of retired Americans stay healthy after they leave the workforce. And every year, as technologies advance and health care demands evolve, Medicare plans change to serve the retired population.

If you’re one of the nearly 64 million Americans who benefit from Medicare, keep reading to learn all about the changes to your insurance coverage in 2023. Some may even help keep your bank account balance a little higher.

Reduced premiums

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If you’re enrolled in or plan to enroll in Medicare Advantage, Medicare Part B, and/or Medicare Part D, you can look forward to reduced plan premiums starting in 2023.

The average monthly Medicare Advantage premium will drop around 8%, bringing down the cost from $19.52 to $18, according to the Centers for Medicare & Medicaid Services.

The standard premium for Medicare Part B should drop more than $5, from $170.10 a month to $164.90 per month. And the average premium for a standard Medicare Part D plan will drop 1.8%, from $32.08 a month to $31.50 a month.

A lower deductible for Medicare Part B

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The deductible for Medicare Part B is set to decrease by $7 a month, to $226 annually. Hopefully, that will make it easier for retirees to hit their deductibles and pay less for medical care out of pocket.

A $35 cap on monthly insulin expenses

Sherry Young/Adobe human insulin vials

In 2022, a person on Medicare who needs insulin injections has copays of between $10 and $1,300 per month.

Starting next year, insulin expenses will be capped: You won’t pay more than $35 out of pocket for a month’s worth of insulin supplies.

That cap doesn’t change even if you haven’t met your deductible — as long as you were prescribed insulin and have a Medicare plan with prescription drug coverage, $35 is the maximum you’ll pay. That should help to keep you out of debt.

Changes to income-related premium adjustments for Medicare Part B

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Your premium for Medicare Part B depends in part on your income level. 

While most Americans pay a standard monthly premium (the new rate of $164.90), around 7% of all Medicare Part B beneficiaries have higher income levels that require them to pay higher Medicare Part B premiums.

For 2022, individuals who made more than $91,000 a year (or couples who made more than $182,000 jointly) were considered high earners who paid a higher Medicare Part B premium.

However, for 2023, the income requirement for a premium adjustment has been raised to more than $97,000 for an individual or more than $194,000 for a couple.

Changes to inpatient hospital deductibles and coinsurance amounts with Medicare Part A

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Medicare Part A plans help cover expenses like inpatient hospital stays and rehab. In 2022, the deductible beneficiaries had to pay for hospital admission was $1,556. That amount has increased by $44. So, in 2023, your inpatient hospital deductible amount will be $1,600.

Coinsurance payments for hospital stays have gone up too. While Medicare will help cover the first 60 days of a long-term hospital stay, beneficiaries must pay $400 a day through coinsurance from day 61 to 90. (In 2022, the daily coinsurance amount was $389.)

The cost of coverage for so-called “lifetime reserve days” — which kick in after you have exhausted the 90 days in a benefit period — rises to $800 a day, up from $778 per day in 2022.

Additional circumstances qualify your for special enrollment

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Typically, you can only enroll in or make changes to your Medicare plan during a brief open enrollment period, which is Oct. 15 to Dec. 7. 

However, a few extenuating circumstances can create a special enrollment period where you have 60 days before or after the qualifying event — like moving out of your coverage zone — to change your plan.

For 2023, some additional circumstances may qualify you for a special enrollment period, including incarceration, loss of Medicaid health care coverage, and disasters or national emergencies that impact you.

$0 out-of-pocket lung cancer screenings

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Some individuals with Medicare now may qualify for free preventative lung cancer screenings.

If you’re between 50 and 77 years old, smoked a pack a day (or more) for two decades, currently smoke or quit no more than 15 years ago, and aren’t experiencing typical lung cancer symptoms, your Medicare plan might cover a free lung cancer screening.

More coverage for post-kidney-transplant immunosuppressive drugs

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This year, Medicare covered the immunosuppressive drugs you’re required to take after a kidney transplant for a period of 36 months.

But next year, if you don’t have any other sources of health care coverage beyond Medicare, Medicare will continue to cover your immunosuppressive drugs beyond that 36-month limit. To get this coverage, you must be signed up for Medicare Part B.

Additional vaccines with no out-of-pocket costs

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Many vaccines are already free — meaning available without a required out-of-pocket copay — for Medicare beneficiaries. These include flu shots, pneumonia shots, and COVID-19 shots and boosters.

In 2023, a two-shot vaccine for shingles will also be covered with no out-of-pocket costs.

Changes to prescription drug coverage through 2025

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Along with the Medicare changes going into effect this year, several crucial changes will be implemented in Medicare over the next two years. Most importantly, starting in 2025, there will be a $2,000 cap on out-of-pocket costs for prescription drugs.

Individuals with prescription drug coverage through Medicare will also be able to pay for their prescriptions monthly instead of with an upfront lump sum.

Additionally, in 2024, Medicare beneficiaries who earn less than 150% of the federal poverty level will receive extra aid to make prescription drugs more affordable.

Bottom line

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If you’re eligible for Medicare, you can review your current plan or sign up for the first time between Oct. 15 and Dec. 7. Don’t wait until the last second to secure your coverage: Make sure you can access Medicare benefits by completing your open enrollment soon.

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Author Details

Michelle Smith Michelle Smith has spent a decade writing for and about small businesses. She specializes in all things finance and has written for publications like G2 and SmallBizDaily. When she's not writing for work at her desk, you can usually find her writing for pleasure near large bodies of water.

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