Medicare Changes 2023
The Medicare changes 2023 includes the 2023 benefits and major changes in Part B enrollment rules. The standard benefit changes for 2023 Medicare A and B benefits are listed below. This includes premiums, deductibles and copays. In addition, there are some changes to part B enrollment time frames. There are also some notable changes to the Medicare Part D model plan design which is detailed below.
Rather learn about this information via a recorded webinar? Review our webinars on YouTube
Big changes to Medicare Part B enrollment
The Beneficiary Enrollment Notification and Eligibility Simplification Act (BENES ACT) creates some major changes for Medicare Beneficiaries effective 1-1-2023.
Changes to Part B enrollment
- Those in the last 3 months of their Medicare Part B IEP will be able to get a part B effective date the month after they apply!
- Those applying for Medicare Part B through the Medicare Part B General Election Period will have their Medicare B start the month after they apply. They will no longer need to wait for a July 1 start date!
- There will be a number of Medicare Part B SEP’s for those applying outside of their IEP or the Medicare GEP
- Those that had an emergency or disaster during their Medicare B IEP or Medicare B GEP
- An employer or health plan made an error or material misrepresentation of information as it relates to the members Medicare enrollment
- Those formerly incarcerated
- Those that lose Medicaid
Medicare Changes 2023: Part A of Medicare
The Medicare Part A premium and deductible will be changing slightly for 2023. Medicare Part A includes inpatient hospital, skilled nursing, hospice, inpatient rehab and some home health care services.
- Inpatient hospital deductible (if admitted): Changing from $1,556 in 2022 to $1,600 in 2023
- Co-insurance will be $400 per day from day 61 through 90 ($389 in 2022)
| Part A Co-insurance and deductible cost comparison for 2022 and 2023 |
||
| 2022 | 2023 | |
| Inpatient hospital deductible | $1,556 | $1,600 |
| Daily coinsurance for 61st-90th Day | $389 | $400 |
| Daily coinsurance for lifetime reserve days | $778 | $800 |
| Skilled Nursing Facility coinsurance | $194.50 | $200.00 |
Medicare Part A monthly premiums
Medicare enrollees age 65 and over with fewer than 40 coverage quarters and people with disabilities may voluntarily enroll in Medicare Part A at no monthly cost. Those with at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a monthly premium. The premium will be $278 a month starting in 2023. This is $4.00 more a month than 2022. Individuals without other coverage and less than 30 quarters of coverage and individuals with disabilities without other coverage or have exhausted other entitlement will pay the full premium. The amount in 2023 will be $506 a month. This is an increase of $7.00 a month compared to 2022.
Medicare changes 2023: Part B of Medicare
- Medicare Part B premium for 2023: Monthly B premium will be $164.90 which is a reduction of $5.20 a month compared to 2022
- Annual Medicare Part B deductible: The deductible for 2023 will be $226 which is a reduction of $7.00 a month from 2022
Medicare Changes 2023: IRMAA (Income Related Monthly Adjustment Amount)
Those with higher incomes pay more for the monthly Medicare Part B premium. Please keep in mind, IRMAA income is based on the income of the individual from 2 years prior to the current year. It is adjusted every year going forward.
| Full Part B Coverage | |||
| Beneficiaries who file individual tax returns with modified adjusted gross income: | Beneficiaries who file joint tax returns with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly
Premium Amount |
| Less than or equal to $97,000 | Less than or equal to $194,000 | $0.00 | $164.90 |
| Greater than $97,000 and less than or equal to $123,000 | Greater than $194,000 and less than or equal to $246,000 | $65.90 | $230.80 |
| Greater than $123,000 and less than or equal to $153,000 | Greater than $246,000 and less than or equal to $306,000 | $164.80 | $329.70 |
| Greater than $153,000 and less than or equal to $183,000 | Greater than $306,000 and less than or equal to $366,000 | $263.70 | $428.60 |
| Greater than $183,000 and less than $500,000 | Greater than $366,000 and less than $750,000 | $362.60 | $527.50 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | $395.60 | $560.50 |
Immunosuppressive Drug Coverage only
Beginning in 2023, Medicare enrollees who are 36 months after kidney transplant and no longer eligible for Medicare , have the option to continue Part B to cover immunosuppressive drugs. There will be a premium of $97.10 to do so. This program will coordinate with MSP for those eligible for the program.This is a limited Part B that will cover immunosuppressive drugs only.
The 2023 Part B monthly premiums for higher earning beneficiaries with immunosuppressive drug only Part B coverage are listed in the table below:
| Part B Immunosuppressive Drug Coverage Only | |||
| Beneficiaries who file individual tax returns with modified adjusted gross income: | Beneficiaries who file joint tax returns with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly
Premium Amount |
| Less than or equal to $97,000 | Less than or equal to $194,000 | $0.00 | $97.10 |
| Greater than $97,000 and less than or equal to $123,000 | Greater than $194,000 and less than or equal to $246,000 | $64.70 | $161.80 |
| Greater than $123,000 and less than or equal to $153,000 | Greater than $246,000 and less than or equal to $306,000 | $161.80 | $258.90 |
| Greater than $153,000 and less than or equal to $183,000 | Greater than $306,000 and less than or equal to $366,000 | $258.90 | $356.00 |
| Greater than $183,000 and less than $500,000 | Greater than $366,000 and less than $750,000 | $356.00 | $453.10 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | $388.40 | $485.50 |
Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
| Full Part B Coverage | ||
| Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly Premium Amount |
| Less than or equal to $97,000 | $0.00 | $164.90 |
| Greater than $97,000 and less than $403,000 | $362.60 | $527.50 |
| Greater than or equal to $403,000 | $395.60 | $560.50 |
Medicare Changes 2023: Higher earning beneficiaries with immunosuppressive drug only Part B coverage that are married and lived with their spouse at any time during the year, but file a separate return.
| Part B Immunosuppressive Drug Coverage Only | ||
| Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly Premium Amount |
| Less than or equal to $97,000 | $0.00 | $97.10 |
| Greater than $97,000 and less than $403,000 | $356.00 | $453.10 |
| Greater than or equal to $403,000 | $388.40 | $485.50 |