Important Medicare Changes in 2023

• by Christian Worstell
• November 9, 2022
• Reviewed by John Krahnert

The Centers for Medicare & Medicaid Services (CMS) announced 2023 Medicare changes in Sept. 2022, to include changes in premiums and deductibles for Medicare Part A, Part B, Medicare health plans and Medicare prescription drug coverage.¹

We’ve compiled a list of everything new or different about Medicare in 2023, including cost changes, new benefits and more.

• 2023 Medicare Part B changes
• 2023 Medicare Part A changes
• 2023 Medicare Advantage (Part C) changes
• 2023 Medicare drug coverage changes (Medicare Advantage prescription drug plans and Part D drug plans)
• 2023 Medicare Supplement (Medigap) changes

It's especially importing during fall Medicare open enrollment to fully review your potential 2023 Medicare costs and plan accordingly.

Medicare Part B costs go down in 2023

The costs of Medicare Part A and Part B (known together as Original Medicare) generally change every year, and usually they go up. But in 2023, certain costs will change in the favor of beneficiaries.

2023 marks the first time since 2012 that either the Part B premium or deductible has decreased.

2023 Medicare Part B deductible

The Part B deductible for 2023 is $226 per year. This is compared to the $233 deductible in 2022.

2023 Medicare Part B premiums

The standard Medicare Part B premium is $164.90 per month in 2023. This is down $5.25 (a 3% decrease) from $170.10 per month in 2022. Higher-income earners may pay higher premiums for their Part B benefits through what's called the 2023 Part B IRMAA (income-related monthly adjustment amount).

Medicare Part A costs go up in 2023

While Medicare Part B becomes a little bit more affordable, 2023 Medicare Part A costs are set to go up. 

2023 Medicare Part A deductible

The Medicare Part A is $1,600 per benefit period in 2023. This is up from $1,556 in 2022.

• The Part A deductible is applied to each benefit period, which begins the day you are admitted for inpatient hospital or skilled nursing facility care and ends once you have gone 60 consecutive days without inpatient care.
  
  
• This means you could potentially experience multiple benefit periods in a single year, and you'd need to meet the Part A deductible amount each time before your Part A benefits kick in.

Medicare Part A daily copayments for inpatient care also increased in 2023.

• 2023 Part A copayments for days 61-90 of an inpatient hospital stay are $400 per day (up from $389 per day in 2022).
  
  
• Inpatient hospital stays that last longer than 90 days require you to use lifetime reserve days (you have 60 total to use in your lifetime). 2023 Part A copays for lifetime reserve days are $800 per day (up from $778 in 2022).
  
  
• The 2023 Medicare Part A copay for inpatient stays at skilled nursing facilities is $200 per day for days 21-100. This is up from $194.50 2022.

2023 Medicare Part A premiums

The Part A premium (for those who must pay it) costs $278 to $506 per month in 2023, depending on your work history.

• Most people don't pay a premium for Medicare Part A. The amount you pay for Medicare Part A depends on the number of years you’ve paid Medicare taxes. 
  
  
• Part A premiums are up from the 2022 range of $274 to $499. 

Medicare Advantage (Part C) premiums go down, out-of-pocket limits go up

Average 2023 Medicare Advantage premium

According to the CMS, the average monthly premium for a Medicare Advantage (Medicare Part C) plan is $18 per month in 2023 when weighted by enrollment.² 

Average 2023 Medicare Advantage maximum out-of-pocket limit (MOOP)

Meanwhile, the maximum out-of-pocket limit (MOOP) for Medicare Advantage plans will be $8,300 in 2023.³ This means after you spend $8,300 out of pocket on covered Medicare services, your plan will cover the costs of your covered care for the remainder of the year.

This annual Medicare spending limit up from $7,550 in 2022. It's important to note, however, most Medicare Advantage plans have out-of-pocket limits that are lower than the established maximum. ​

Medicare Part D changes to costs and benefits

Average 2023 Medicare Part D plan premium

The average premium for a Medicare Part D plan is $31.50 per month in 2023. This is down slightly from the 2022 average of $32.08 per month.²

2023 Medicare Part D deductible

The maximum allowable deductible for 2023 Part D plans is $505, though some plans have deductibles that are lower than the maximum. The 2023 Part D deductible is up from $480 in 2022.

2023 Medicare Part D donut hole

After you and your Medicare drug plan spend $4,660 on covered drugs in 2023, you enter what's called the Medicare donut hole coverage gap. While you're in the gap, you pay no more than 25% of the cost for covered brand-name or generic drugs.

The 2023 Medicare Part D drug plan catastrophic coverage phase begins once you and your plan have combined to pay for $7,400 of covered drugs in the year. Once you spend this amount, your drug plan will cover your covered drugs for the rest of the year with minimal copay/coinsurance costs to you.

Medicare Advantage and Medicare Part D plan members will receive a letter in the mail each fall called an Annual Notice of Change. This letter details any changes to the plan and it’s important to review the notice each year so you can determine if you wish to remain in the plan or shop for a different plan during the Annual Enrollment Period (AEP), also called the fall Medicare open enrollment period. 

2023 Medicare Part D benefits for insulin, vaccines and drug costs

Each new year typically welcomes some new or expanded benefits to Medicare. Some years have more changes than others, and in 2023 there are three key coverage expansions. 

• As a part of the Inflation Reduction Act, beneficiaries with drug coverage through a Medicare Advantage or Part D plan will have access to more free vaccines like shingles and Tdap (tetanus, diphtheria and pertussis). Prior to 2023, these vaccines required patient cost-sharing.
  
  
• Another result of the Inflation Reduction Act is that Medicare beneficiaries who use insulin will pay no more than $35 for a one-month supply of insulin and covered insulin products.
  
  
• Beneficiaries who qualified for Medicare because of kidney failure and undergo a kidney transplant will now have their immunosuppressive drugs covered for the rest of their lives instead of just the 36-month limit that was previously in place. 

Medicare Supplement (Medigap) deductibles and out-of-pocket limits go up

2023 Medicare Supplement Deductibles

Medicare Supplement Insurance (Medigap) Plan F and Plan G have high-deductible versions in which beneficiaries pay a lower monthly premium in exchange for having a deductible. In 2023, the deductibles for high-deductible Plan F and Plan G are $2,700 per year. This is an increase from $2,490 in 2022. 

2023 Medicare Supplement maximum out-of-pocket spending limit

Two Medigap plans contain an annual out-of-pocket limit, and those too are on the up in 2023.

• The out-of-pocket maximum for Plan K is $6,940 in 2023 (up from from $6,620 in 2022)
• The out-of-pocket maximum for Plan L is $3,470 in 2023 (up from $3,310 in 2022)

Special Medicare enrollment periods expanding

Before 2023, someone who didn't sign up for Medicare when they first became eligible would be able to do so later, without penalty, during a Special Enrollment Period. This only applied, however, if they were still covered by employer or other qualified health insurance.

But beginning in 2023, qualification for Special Enrollment Periods will be expanded to include those who missed their Initial Enrollment Period because of natural disasters, emergencies and other events.

If you're approaching Medicare eligibility or if you currently have Medicare but need to compare your 2023 coverage options, a licensed insurance agent can help you compare Medicare Advantage plans available where you live, including their costs, benefits, network restrictions and more.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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