There are many changes coming to Medicare this year due to the passage of the Inflation Reduction Act and other Medicare policies. Some changes will affect everyone on Medicare with adjustments to premiums, deductibles, and prescription costs.  Other changes will impact people who are new to Medicare with new rules for enrollment periods and effective dates. Here are the highlights of the 2023 changes:

Premium and Deductible Changes

The Part B premium is going down for the first time since 2012. The Part B premium for 2023 will be $164.90, which is down $5.20 from 2022. The Part B deductible for 2023 will also go down. The 2023 Part B deductible will be $226, which is $7 lower than 2022.

Part D Prescription Drug Changes

Beneficiaries with diabetes will see a cap on what they pay for insulin on a Medicare Part D plan. Starting January 2023, Part D enrollees will not pay more than $35 per month for Part D covered insulin. Also beginning in 2023, any vaccines that are ACIP-recommended must be covered without a co-pay.  This is a big deal for the shingles vaccine since the typical Medicare Beneficiary who hadn’t paid their Part D deductible was paying about $200 out of pocket for the vaccine.  DTaP is another common vaccine recommended for seniors that was subject to Part D deductible. These will no longer be subject to a deductible and there will be no copayment to get them.

Looking forward to 2024 and 2025: Under the Inflation Reduction Act, there will be more changes coming to Part D plans in 2024 and 2025. Beginning in 2024, people with Medicare Part D coverage who have drug costs high enough to reach catastrophic coverage won’t have to pay any cost-sharing once they reach the catastrophic phase of the benefit for their covered Part D drugs.  2025 will welcome a maximum out-of-pocket drug spending cap of $2,000 annually for Part D plans. This means that beginning in 2025, people with Medicare Part D won’t pay more than $2,000 per year in out-of-pocket costs for covered Part D drugs (and for subsequent years, this amount will be indexed by inflation). Part D enrollees will also be able to choose to pay their out-of-pocket Part D costs in monthly amounts spread over the plan year.

Initial Enrollment Period (IEP) Coverage Start Date Changes

Starting January 1, 2023, your Medicare Part B coverage starts the first day of the month after you sign up for Medicare during the last three months of your 7-month Initial Enrollment Period. The Initial Enrollment period is the three months before your 65th birthday, the month of your 65th birthday, and three months after your 65th birthday. Before this change, if you signed up during the last three months of your IEP, your Medicare Part B coverage started two to three months after you enrolled. It will now begin the following month, with no waiting period.

General Enrollment Period (GEP) Changes

There will also be changes to the General Enrollment Period for 2023. If you don’t sign up for Medicare Part B during your IEP, you have another chance each year during the General Enrollment Period (GEP). The GEP lasts from January 1 through March 31. Under the 2022 rules, you would have waited for coverage to start until July 1. Starting January 1, 2023, your coverage starts the first day of the month after you sign up.

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