Medicare coverage and costs normally change each year, so it is important to understand and review your benefits. Here is an overview of what’s new in 2023.
Part A
Medicare Part A covers inpatient hospital services, skilled nursing facility services, home health care, and hospice. Most people do not owe a premium for Part A, but if neither you nor your spouse have 10 years of Social Security work credits, you may owe a monthly premium. If you are admitted to the hospital as an inpatient, you will owe a deductible of $1,600 at the beginning of your stay. If you have multiple hospitalizations, you may owe the deductible more than once. After you meet your deductible, your first 60 days in the hospital and your first 20 days in a skilled nursing facility cost $0 per day. After that, you owe an out-of-pocket cost for each day of your continued stay.
Part B
Medicare Part B covers outpatient costs, such as doctor visits and lab tests. In 2023, the standard monthly Part B premium is $164.90, which is a decrease from the 2022 premium. If your income is above $97,000 as a single person or $194,000 as a married couple, you may pay a higher premium, known as an Income Related Monthly Adjusted Amount (IRMAA). Part B coverage includes a deductible of $226 during 2023. You will continue to owe 20% coinsurance for most services covered by Part B. Thanks to the Inflation Reduction Act, you will pay no more than a $35 copay for each Part B-covered insulin product, starting in July of 2023. Insulin products that may be covered by Part B include a pump and the insulin that is used with the pump.
Part D
Medicare Part D covers outpatient prescription drugs. Your premium and drug costs vary based on your plan and your prescription drug needs. If your Part D plan has an annual deductible, it can be no higher than $505 in 2023. Thanks to the Inflation Reduction Act, all Part D-covered vaccines, including the shingles vaccine, will be $0. Additionally, copays for each Part D-covered insulin product will be limited to a maximum $35 copayment.
Insulin products that may be covered by Part D include insulin that is not used with a pump, along with medical supplies used to inject insulin, like syringes, gauzes and alcohol swabs. Part D coverage gap thresholds and catastrophic coverage limits have also been inflation adjusted.
Enrollment periods and coverages
The Initial Enrollment Period (IEP) is the seven-month period including the three months before, the month of, and the three months following your 65th birthday month. For most people, your Medicare coverage begins on the first day of your 65th birthday month. If your enrollment is completed during your birthday month, or in one of the following three months, then your Medicare coverage will begin on the first day of the next month. This change shortens the gap in coverage for those who enroll later during their IEP. As a reminder, enrollment into Original Medicare begins by contacting the Social Security Administration.
The General Enrollment Period (GEP) runs from January 1 through March 31. Beginning in 2023, when you enroll during the GEP, your Medicare will begin the first of the month after you enroll. For example, if you enrolled during February in past years, you would have to wait until July 1 for your Medicare to start. Now, if you enroll using the GEP in February, for example, your coverage will instead start on March 1.
Special Enrollment Periods (SEPs) are periods of time outside normal enrollment periods when you can enroll in Medicare or change your coverage. SEPs are sometimes triggered by specific life circumstances that create more enrollment opportunities, reduce gaps in coverage, and prevent late enrollment penalties. If you missed an enrollment period and think you may qualify for a Special Enrollment Period, contact our Medicare Information Office to learn more.
For any Medicare related questions, please feel free to contact the State of Alaska Medicare Information Office at 800-478-6065 or 907-269-3680; our office is also known as the State Health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers (MIPPA) program.
If you are part of an agency or organization that assists seniors with medical resources, consider networking with the Medicare Information Office. Call us to inquire about our new Ambassador program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor at the Alaska Medicare Information Office.
