The enrollment period is the time of year when people with Medicare can make unrestricted changes to their coverage options.
If you’re already enrolled, it’s still worth reviewing your options for 2023, especially in light of several changes to the program.
“During the enrollment period, Medicare beneficiaries can review how they receive their Medicare coverage for 2023,” Judith Stein, JD, the executive director of the Center for Medicare Advocacy, told Verywell.
Stein said that whether people have traditional Medicare with a Part D prescription drug plan or are enrolled in a private Medicare Advantage plan, “all beneficiaries should make sure that the options available to them will meet their needs in the coming year.”
Key Changes for 2023
While you may have heard that Congress recently passed a law allowing Medicare to negotiate some drug prices, that doesn’t begin until 2026. However, there are some key changes for 2023.
Lower Costs for Part B
Many people will see small decreases in their Part B premium and deductible. The standard monthly Part B premium in 2023 will be $164.90, down from $170.10 in 2022. The annual Part B deductible decreases to $226, down from $233 in 2022.
Lower Premiums for Part D
The base premium for a Medicare Part D prescription drug plan will be $32.74 per month, down from $33.37 in 2022. However, premiums for specific plans and regions vary from year to year and may be higher or lower, according to the Medicare Rights Center. That means it’s important for people to carefully examine their Annual Notice of Change (ANOC) to determine if and how their plan’s costs or benefits are changing and if it makes sense to explore other options.
You should have received the ANOC by September 30 via email or regular mail. Didn’t get it? Call your plan.
Copay Limits for Insulin
Copays for insulin for all beneficiaries will be limited to $35 per month. This applies to all insulin covered by a beneficiary’s Part D plan or under Medicare Part B.
Coverage for Vaccines
People with Medicare will pay no copays or deductibles for some vaccines covered by their Part D plan, including the shingles vaccine and flu shot. For now, COVID-19 vaccines and boosters remain free with no copay for all Americans.
Higher Barriers to the Coverage Gap and Catastrophic Coverage
Not all Medicare numbers are going down. Medicare beneficiaries will enter the coverage gap—where they pay out of pocket for medications—after their total drug costs reach $4,660 (up from $4,430 in 2022). Once in the coverage gap, beneficiaries have a 75% discount on the cost of brand name and generic drugs.
If Medicare beneficiaries have spent enough money out of pocket while in the coverage gap, they may qualify for something called “catastrophic coverage.” During this period, people pay significantly lower copayments or coinsurance for covered drugs. In 2023, beneficiaries will reach catastrophic coverage after paying $7,400 out of pocket on drugs (up from $7,050 in 2022).
What If I Have a Medicare Advantage Plan?
Medicare Advantage plans are private plans you can enroll in instead of original Medicare. They are often area-specific.
Medicare Advantage plans limit your choice of physicians to those who participate in your plan, but may also add some benefits, such as vision care and coverage of rides to the doctor.
“You can reevaluate your choice every year and make sure you’re enrolled in the coverage that’s best for you,” Jane Sung, JD, a senior strategic policy advisor for AARP told Verywell, explaining new plans may become available in your area in 2023.
According to Stein, Medicare Advantage plans should consider the following questions during the enrollment period:
Will my doctors, health care providers, hospitals, and healthcare institutions be in my plan next year?Will my medications be included in a drug plan, within Medicare Advantage, or in Part D?
“Most people don’t take advantage of open enrollment opportunities as much as perhaps they should,” Sung said. “Now is a good time to look at your own coverage priorities and to be aware that there are a lot of different choices out there. Enrollment is a process that can take some time to get through.”
If you have a Medicare Advantage or Part D plan, you should review all your coverage options, even if you are happy with your current coverage, because plans change each year.
