Medicare beneficiaries are getting a rare bit of good news as their Part B premiums and deductibles will tick down next year after the government health insurance plan spent less than projected in 2022. Unfortunately, the cost reductions beneficiaries will see next year are much smaller than the increases they shouldered this year. But costs will also go down for Medicare Advantage and Medicare Part D prescription drug plans. At the same time, deductibles for hospitalization costs under Part A will be going up. If you’re new to Medicare and wondering what these letters are all about, we’ll get to that – see Medicare Open Enrollment Presents Choices, below.
The Centers for Medicare and Medicaid Services has announced the standard Medicare premiums for Part B beneficiaries will be $164.90 a month in 2023, down $5.20 from the $170.10 monthly charge in 2022, or about 3% less. The annual deductible for all Medicare Part B beneficiaries will be $226 in 2023, which is $7 less than the 2022 deductible of $233.
CMS projects the average basic monthly premium for standard Part D coverage will be $31.50, compared to $32.08 in 2022.
Because of the Inflation Reduction Act, beneficiaries with Medicare prescription drug coverage will pay less for their drugs, including a $35 cost-sharing limit on a month’s supply of insulin. In addition, vaccines recommended by the Advisory Committee on Immunization Practices will be covered by Medicare with no cost sharing or deductibles.
Medicare Costs Went Up in 2022
The reductions come after more significant increases in costs for 2022, compared to 2021. Then. the premium went up 14.5%, or $21.60. The annual Part B deductible increased $30 in 2022, compared to 2021.
CMS said the 2022 increases were attributed to rising health care costs and expected spending on the newly approved Alzheimer’s drug, Aduhelm. Aduhelm’s price tag was then put at $56,000 per person each year. However, drug maker Biogen later cut the annual price to $28,200. And Medicare decided to cover the drug only for people with diagnoses of mild cognitive impairment due to Alzheimer’s who are participating in clinical trials.
According to CMS, lower-than-planned “spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund, which can be used to limit future Part B premium increases.”
CMS also announced that starting next year, “certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium.” The premium in 2023 will be $97.10.
Medicare Open Enrollment Presents Choices
Medicare Open Enrollment will be Oct. 15 through Dec. 7. During this time, Medicare enrollees are encouraged to review their coverage to determine if their needs have changed.
Medicare Part B is the general insurance that covers items like doctors and other health care providers, outpatient and home health care, as well as medical equipment and preventive services like vaccines and yearly wellness visits.
Part A covers inpatient hospitalizations, care in skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services. It generally does not impose a premium.
Part D provides prescription drug coverage through private insurance companies
The other option is known as Part C or Medicare Advantage. This is a private insurance plan that takes the place of Part B and often Part D.
According to CMS, the projected average premium for 2023 Medicare Advantage plans is $18 per month, a decline of nearly 8% from the 2022 average premium of $19.52.
Part A Deductibles Rising
The Part A deductible for hospital admissions will increase by $44 in 2023 to $1,600. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.
For patients who are hospitalized for longer than 60 days, the coinsurance amount will increase in 2023 from $389 a day to $400 a day for the 61st through the 90th day of hospitalization and from $778 a day to $800 the day after that. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will increase from $194.50 to $200.
Medicare beneficiaries may also choose to purchase a private, supplemental insurance plan, known as medigap to help cover deductibles and copays.
Part B monthly standard premiums apply for individuals who make $97,000 or less a year and couples earning $194,000. They are higher for people with higher incomes. For example, individuals who make more than $97,000 up to $123,000 and couples who make more than $194,000 and up to $246,000 will be charged an additional monthly premium of $65.90 for Part B and $12.20 for Part D . At the high end, individuals who make $500,000 a year or more will be charged an extra $395.60 for a total of $560.50 a month for Part B and an additional $76.40 for Part D next year.
The income limits mark an increase over 2022, when standard premiums were applied for individuals who made up to $91,000 a year and joint filers who made $182,000 annually.
The extra charges are also known as the income-related monthly adjustment amount or IRMAA. According to CMS, about 7% of Part B beneficiaries face these surcharges.