What are the Main Changes to Medicare in 2023?

2022 is coming to an end, which means it’s time to review your health insurance coverage for 2023. Qualifying Americans are given the opportunity to enroll or adjust their Medicare coverage once per year. This year, the open enrollment period begins on October 15, 2022 and closes on December 7, 2022.

We get it, spending your precious downtime reading about health insurance is far from fun. Having said that, using the open enrollment period to your advantage is essential to ensuring that you aren’t paying more than you should. It’ll also ensure that you’re always making the most of the year’s most notable Medicare changes.

What is Medicare?

Approximately 18.5% of the U.S. population is on Medicare, with that number projected to grow as America’s average age continues trending upwards. This federally funded health insurance program is designed to provide comprehensive health coverage to seniors and qualifying younger people.

There’s a popular misconception that Medicare is free. Sadly, it’s not. Medicare health plans do charge monthly premiums, and there are deductibles. It doesn’t provide coverage for dental, hearing, or vision care either.

Who is Eligible for Medicare?

Medicare isn’t available for everyone. For starters, prospective enrollees must be U.S. citizens or legal permanent residents with established residency of at least five consecutive years.

Seniors who are 65 or older are eligible for Medicare, but there are some exceptions. Certain younger people with disabilities may be eligible to receive federal health insurance through Medicare. People with permanent kidney failure requiring dialysis or a transplant, often referred to as End-Stage Renal Disease, are eligible for Medicare too.

How Are Medicare Parts A, B, C, and D Different?

Medicare coverage is divided into multiple parts. Each part is designed and offered to help cover different categories of medical services. Though many enrollees aren’t required to pay a monthly premium for Part A Medicare coverage, Parts B, C, and D coverage come with a price tag. How much each part costs can vary depending on the plan, but here’s a general overview of what each part is used for.

Part A

• Usually called “hospital insurance”.
• Can help cover costs associated with hospital stays, hospice care, and nursing care.

Part B

• Usually called “medical insurance”.
• Can help cover the cost of outpatient care, doctors appointments, medical equipment, and lab tests.

Part C

• Usually called “Medicare Advantage”.
• Offers an expanded menu of coverage options, including dental and vision care, and is usually provided by a private insurer.

Part D

• Usually called “drug coverage”.
• Can help cover the cost of some prescription drugs.

What are the Main Changes to Medicare in 2023?

The official U.S. government Medicare handbook, “Medicare & You” has been released and highlights a number of new and important changes coming into effect on January 1, 2023. The headline-stealing Inflation Reduction Act that was signed into law on August 16 of this year put in place a significant change to Medicare too.

Here’s a brief breakdown of the main changes to Medicare in 2023:

• Thanks to the Inflation Reduction Act, insulin copays for Medicare enrollees with Part D coverage will be capped at $35 a month.
• Those with End Stage Renal Disease will continue receiving coverage for immunosuppressive drugs beyond 36-months after a kidney transplant, even without other health coverage.
• Medicare will continue covering certain COVID-19 related services and treatments including vaccines, antibody tests, home tests, and monoclonal antibody treatment.
• Eligible seniors that sign up for Medicare in the month that they turn 65, or during the last 3-months of their Initial Enrollment Period, or during the General Enrollment Period, will begin receiving coverage the first day of the month after signing up.
• Those that missed the enrollment period due to exceptional circumstances may be able to qualify for a Special Enrollment Period.

How to Choose the Right Coverage?

Taking the time to review the changes to Medicare and your health coverage for the coming year is always worth your time. Policies change and prices fluctuate, but so do your healthcare and financial needs. The only way to ensure that your Medicare coverage remains up to date is to research, seek advice, and use the 54-day open enrollment window to your advantage every single year.

This year, seniors over the age of 65 and qualifying younger Americans are given the opportunity to review and change their Medicare coverage starting on October 15, 2022 and ending on December 7, 2022. There’s no second chances either. So be sure to understand how the latest changes to Medicare might affect you, and adjust your coverage accordingly.