The Centers for Medicare & Medicaid Services [CMS] have announced the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs.
A decrease in the 2023 Part B premium reflects the recommendation of CMS from a May 2022 report. As a result of lower-than-projected spending on both Aduhelm™, a drug used in treating Alzheimer’s disease, and other Part B items and services, it was decided to distribute the surplus to Medicare Part B beneficiaires via an overall Part B premium discount.
Listen to this article:
Part B Premium Reflects Decrease for All Medicare Part B Beneficiaries
On Tuesday, September 27, CMS announced that the monthly Medicare Part B premium will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for Medicare Part B beneficiaries decreased $7, from $233 in 2022 to $226 in 2023.
New for 2023, certain Medicare enrollees who are 36 months post kidney transplant, making them ineligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium of $97.10 for 2023.
Here’s how your clients’ annual incomes will affect their Medicare Part B monthly premiums for 2023.
| $97,000 or Less | $194,000 or Less | $0.00 | $164.90 |
| $97,001 to $123,000 | $194,001 to $246,000 | $65.90 | $230.80 |
| $123,001 to $153,000 | $246,001 to $306,000 | $164.80 | $329.70 |
| $153,001 to $183,000 | $306,001 to $366,000 | $263.70 | $428.60 |
| $183,001 to $500,000 | $366,001 to $750,000 | $362.60 | $527.50 |
| $500,000 or More | $750,000 or More | $395.60 | $560.50 |
| $97,000 or Less | $0.00 | $164.90 |
| $97,001 to $402,999 | $362.60 | $527.50 |
| $403,000 or More | $395.60 | $560.50 |
Part A
Medicare Part A is premium-free for more than 99 percent of beneficiaries. Less than one percent of Medicare beneficiaries must pay the Part A premium because they do not have at least 40 quarters of Medicare-covered employment. Those who have paid Medicare taxes for less than 30 quarters will pay a Part A premium of $506 per month in 2023, up from $499 per month in 2022 — a $7 increase. Beneficiaries who have paid Medicare taxes for at least 30 quarters or were married to someone with at least 30 quarters of coverage will pay a Part A premium of $278 per month in 2023, up from $274 per month in 2022.
The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital for 2023 will be $1,600, which is an increase of $44 from $1,556 in 2022.
2023 Part A Deductible & Coinsurance Amounts
| Inpatient Hospital Deductible | $1,556 | $1,600 |
| Daily Coinsurance for Days 61 to 90 | $389 | $400 |
| Daily Coinsurance for Lifetime Reserve Days | $778 | $800 |
| Skilled Nursing Facility Coinsurance | $194.50 | $200 |
● ● ●
The best insurance agents are the most knowledgeable about information like this that directly impacts the abilities of their clients to afford quality Medicare coverage. By staying up to date, you can serve as a well-informed, reliable, and trusted guide for your clients throughout the insurance sales process.
Editor’s Note: Table information is from The Centers for Medicare & Medicaid Services.
In 2023, Medicare Part will cost slightly more, while Part B and Medicare Advantage prices will be lower.
Other changes include cost limits on certain insulin products for all Medicare Part C and Part D plans, free vaccines covered under Medicare Part D and a new Part B benefit that extends coverage after a kidney transplant for anti-rejection drugs.
Being aware of these changes can help you select the best Medicare plan for your needs, whether you're new to Medicare or want to switch plans during a Medicare open enrollment period.
Higher Medicare Part A costs
Medicare Part A costs are increasing by an overall average of 3% for 2023, which is lower than last year's increase.
All Medicare Part A costs are increasing for 2023, including the deductible, coinsurance and premiums.
Most people get Medicare Part A for free and are enrolled automatically when they turn 65. But if you have to pay for Part A, your premiums typically increase yearly.
| Hospital deductible | $1,556 | $1,600 | 3% |
| Hospital coinsurance days 61-90 | $389 | $400 | 3% |
| Hospital coinsurance days 91+ | $778 | $800 | 3% |
| Skilled nursing facility coinsurance days 21-100 | $194.50 | $200 | 3% |
| Monthly rate: Paid Medicare taxes less than 30 quarters | $499 | $506 | 1% |
| Monthly rate: Paid Medicare taxes for 30-39 quarters | $274 | $278 | 1% |
Part A premiums only apply if you paid Medicare taxes for less than 40 quarters.
Part A deductible
You must pay a Part A deductible for each hospital admission. That amount will be $1,600 in 2023, an increase of $44 over 2022.
Part A premiums
Part A continues to be free if you paid Medicare taxes for 10 years or more. If you worked and paid Medicare taxes for less than 7.5 years, you'll pay $506 per month for Part A in 2023, up from $499 a month in 2022. If you paid Medicare taxes for at least 7.5 years but less than 10 years [30 to 39 quarters], you’ll pay $278 a month for Part A in 2023, an increase from $274 in 2022.
Part A coinsurance
After you pay the hospital deductible, you'll pay a set amount — known as coinsurance — for each day you remain in the hospital over 60 days. The 2023 deductible and coinsurance amounts will all increase by 3% from 2022:
- Hospitalization days 1 to 60: You pay the $1,600 deductible if you haven't already met it, but you won't pay any coinsurance for the first 60 days in the hospital.
- Hospitalization days 61 to 90: You pay $400 per day for each benefit period, up from $389 in 2022.
- Hospitalization days 91 and up: You pay $800 for each "lifetime reserve day" for each benefit period, up from $778 in 2022. Medicare enrollees get a maximum of 60 lifetime reserve days.
Skilled nursing facility coinsurance
For days 21 through 100 at a skilled facility, you'll pay $200 per day in 2023, up from $194.50 in 2022.
As in prior years, you pay no coinsurance for your first 20 days at a skilled nursing facility.
Changes to Medicare Part B
Medicare enrollees will pay a lower Part B rate and deductible in 2023.
The cost of Medicare Part B will go from $170.10 per month in 2022 to $164.90 in 2023, a decrease of $5.20 per month.
The Medicare Part B deductible is also decreasing in 2023. The annual Part B deductible will go from $233 in 2022 to $226 in 2023, a decrease of $7.
| Premiums | $170.10 | $164.90 | 3% |
| Annual deductible | $233 | $226 | 3% |
In 2023, Medicare will offer a new Part B plan for people who've had a kidney transplant.
The benefit will extend coverage for drugs that help to keep your body from rejecting a donor kidney — known as immunosuppressive or anti-rejection drugs — beyond the current limit of 36 months.
This new plan only covers anti-rejection drugs, so it isn’t a substitute for full health insurance. The monthly rate is $97.10 for individuals earning $97,000 or less and increases for higher earners.
To sign up, you must call Social Security at 800-772-1213. TTY users can call 800-325-0788.
Medicare Advantage changes for 2023
On average, Medicare enrollees will pay $18 per month for Medicare Advantage in 2023, a decrease from $19 per month in 2022.
Five major Medicare Advantage insurers all plan to expand into new states and counties in 2023. Those shopping for Medicare Advantage plans may find newly available options from Aetna, Cigna, Elevance Health [formerly known as Anthem Inc.], Humana and UnitedHealthcare.
If you have drug coverage through a Part C [Medicare Advantage] or Part D plan, you'll see two important cost and benefit changes for 2023:
- You'll pay no more than $35 per month for certain types of insulin.
- Vaccines recommended by the Advisory Committee on Immunization Practices [ACIP] will be free, including the shingles vaccine.
Medicare Part D changes
The average rate for a standard Medicare Part D plan will decrease from $32.08 in 2022 to $31.50 per month in 2023.
Your other Part D costs will increase for 2023. The maximum Part D deductible will increase from $480 in 2022 to $505 in 2023. The threshold for entering the catastrophic coverage phase — when you get through the donut hole phase and your benefits improve — will go up from $7,050 in 2022 to $7,400 in 2023.
| Average monthly rate | $32.08 | $31.50 | -1% |
| Maximum annual deductible | $480 | $505 | +5% |
| Catastrophic phase threshold | $7,050 | $7,400 | +5% |
Limits on insulin costs
Beginning Jan. 1, 2023, all Medicare Part D and Medicare Advantage plans with prescription coverage will cap the cost of select insulin products at $35.
With this change, you'll pay no more than $35 for a month's supply of insulin.
Starting on July 1, people on Original Medicare who use an insulin pump will also pay no more than $35 for a month's supply of insulin.
Vaccinations under Medicare Part D
Starting in 2023, vaccines covered under Medicare Part D will be free.
This means you pay no deductible, coinsurance or copay for vaccines — even the shingles vaccine — covered by Medicare Part D.
Enrollment period changes for 2023
Medicare is adding a new enrollment period in 2023 to help people affected by certain events like a natural disaster or losing Medicaid.
There are also changes to existing enrollment periods that will get your coverage started earlier.
Extra time to sign up for Medicare through Dec. 30, 2022
An update to the Social Security Administration [SSA] phone system in 2022 made it hard for callers to connect with a representative to enroll in Medicare. If you tried to call the SSA to sign up for Medicare between Jan. 1 and Dec. 30, 2022, but couldn’t get a representative on the phone or were disconnected, Medicare is still offering you an extended period through Dec. 30, 2022, to enroll.
The extension applies if you're trying to sign up during your initial enrollment period [IEP], the general enrollment period [GEP] or a special enrollment period [SEP].
You can find out more at Medicare.gov or by calling 800-772-1213.
New special enrollment period
A new special enrollment period will be available in 2023 to cover exceptional circumstances. This option will help people who miss an enrollment period due to certain events like a natural disaster or another emergency, incarceration or losing Medicaid coverage.
Your time to enroll will depend on the exceptional circumstances. For example, if you're affected by a major disaster, you have four months from the disaster date to enroll in, cancel or switch a Medicare Part C or Part D plan. Your plan change is effective the first of the month after submitting your request.
You can get more information about how to qualify and when to apply at Medicare.gov.
Changes to existing Medicare enrollment periods
To help people avoid coverage delays, Medicare made changes to when Medicare starts for those who join during their initial enrollment period [IEP] and the general enrollment period [GEP].
| Initial enrollment period | Coverage was delayed by two to three months for those enrolling at the end of the IEP. | When signing up the month you turn 65 or during the remainder of the IEP, coverage starts the first day of the following month. |
| General enrollment period | Coverage started July 1 of that year for anyone who enrolled during the GEP. | Coverage starts on the first of the month after signing up during the GEP. |
The initial enrollment period [IEP] is a seven-month period surrounding your 65th birthday. The general enrollment period [GEP] runs from January to March of each year.
Frequently asked questions
What are some Medicare coverage changes for 2023?
Changes to Medicare benefits for 2023 include a $35 cost limit on certain insulin products for all Medicare Advantage and Medicare drug plans. There is also a new benefit for end-stage renal disease [ESRD] patients that helps pay for anti-rejection drugs beyond 36 months after a kidney transplant.
How much will Medicare premiums change in 2023?
Medicare premiums for Part B will decrease by 3% to $164.90 in 2023, the first rate decline in nearly 10 years. If you must pay for Medicare Part A, your premiums will jump by 1%.
What is the Medicare deductible for 2023?
The Medicare Part A deductible for 2023 is $1,600. This is an increase of $44 over the 2022 deductible of $1,556. For Part B, the deductible will decrease to $226 for 2023.
Sources
All Medicare cost, coverage and benefit information was obtained from Medicare.gov and CMS.gov.