The world of Medicare is always evolving. Each year coverage, premiums, deductibles and copayments/coinsurance are likely to change – as well as possible Medicare program changes, too. It’s important to stay up to date. We know you probably have a lot of questions, and that’s why we’re here.

What’s different for Medicare in 2023? Let’s talk through these changes together, so you can get a better understanding of what they mean for you and your coverage.

Key Medicare changes in 2023: Premiums, deductibles and coverage

There are many changes to Medicare in 2023 that will make care and coverage more affordable for those who need it most. Beneficiaries will see lower average premiums this year for Medicare Advantage plans, and due to the Inflation Reduction Act of 2022 (IRA), Part D prescription drug coverage will become more affordable. And these aren’t the only changes you should expect.

2023 Medicare Part A premiums

About 99% of Medicare beneficiaries don’t pay a Part A (hospital coverage) premium. However, for those without premium-free Part A, coverage in 2023 can cost either $278 (a $4 increase from 2022) or $506 (a $7 increase from 2022) each month. This depends on how long you or your spouse worked and paid Medicare taxes. If your income is lower, you may be eligible for a Medicare Savings Program.

2023 Medicare Part B premiums

How much will Medicare Part B cost in 2023? The good news is that the standard monthly Medicare Part B (medical coverage) premium decreased to $164.90 – down $5.20 from 2022. In addition, for those who receive Social Security benefits, this year’s cost-of-living-adjustment (COLA) will be as high as 8.7%. That’s a significant jump from the 5.9% rate of 2022, and it’s the largest overall increase in decades. Unlike in 2022 when many seniors were using their COLA to cover additional Part B premiums, retirees will now be able to use that extra money to cover other expenses.

However, you could pay more than the standard premium if you earn more than $97,000 a year. If you need help with costs, you may also be eligible for a Medicare Savings Program.

2023 Medicare Part D premiums

Based on current enrollment, the average 2023 premium for Part D (prescription drug coverage) plans is projected to decrease 1.8% from last year at $31.50 per month. For those who need help lowering prescription drug costs, you can work with your doctor to shift to generic brands or other lower cost drugs, explore new plan options or you can even apply for Medicare’s Extra Help program.

Most Medicare Advantage plan (Part C) premiums are lower

Are you enrolled in a Medicare Advantage plan (Part C)? Is it something you’ve been considering? Good news: The average Part C premium decreased this year from $19.52 to $18.

Medicare Advantage plans can offer a robust selection of additional benefits, such as hearing, dental and vision care – as well as gym memberships and travel coverage. Plus, most plans do not have a medical deductible and include Part D prescription drug coverage.

Because of this, the number of beneficiaries enrolling in Part C plans is on the rise. It’s estimated that Medicare Advantage plan enrollment will reach 31.8 million enrollees this year – up 3.8 million from 2022. 

One increase Part C beneficiaries may see this year is with the upper limit of the maximum out-of-pocket limit (MOOP) for Medicare Advantage plans, which has risen from $7,550 in 2022 to $8,300. However, many Medicare Advantage plans have out-of-pocket maximums that are lower than this amount – make sure to check with the plan if you have any questions.

Interested in learning more? See if a Medicare Advantage plan is the best option for you.

Medicare deductibles in 2023

This year, in addition to premiums, caps on annual deductibles for Medicare Part A, Part B and Part D have also changed. While costs may vary by plan, here are the maximum amounts you might have to pay to cover a deductible.

  • Part A deductible: $1,600 (up from $1,556 in 2022)
  • Part B deductible: $226 (down from $233 in 2022)
  • Part D deductible: $505 (up from $480 in 2022)

Medicare coverage and benefits changes in 2023

While many aspects of your benefits and coverage have remained the same, 2023 is a big year for Medicare changes. What does this mean for you and your coverage? Here are some important updates.

Big Medicare drug coverage updates

Big things are happening in terms of Medicare drug coverage this year! Due to the Inflation Reduction Act of 2022, all beneficiaries will now see a $35 cost-sharing limit on a month’s supply of Part D select insulin products starting in January 2023. In July 2023, this will expand to include Medicare Part B insulin for those who are using insulin pumps.

Also, starting Jan. 1, all adult vaccines that are recommended by the Centers for Disease Control and Prevention will be available at no cost to Medicare beneficiaries through Medicare Part D prescription drug coverage. This includes most vaccines now available to adults, including the shingles vaccine.

2024 Medicare updates and beyond

These aren’t the only Medicare Part D changes coming down the pipeline. In fact, because of the IRA, there are many updates on the horizon for 2024 and beyond – some of which you might have heard about.

Starting in 2024, Medicare Part D low-income assistance will be expanding to include those with an income at or below 150% of the national poverty level. This will ensure that more people can afford their medicines.

Also starting in 2024, enrollees who enter the Part D catastrophic coverage phase won’t have to pay cost-sharing on additional medicines. And in 2025, Part D out-of-pocket drug costs will be capped at $2,000 and enrollees will be given the opportunity to pay remaining costs in monthly installments rather than in one lump sum.

To get the most out of your benefits, make sure you stay up to date on how your benefits and costs are changing from year to year.