While Congress is currently considering adding benefits and prescription drug cost controls to Medicare, current Medicare participants may have noticed some other Medicare changes that quietly took place this year.
Most notably? An increase in premiums, deductibles, and other out-of-pocket costs.
The Centers for Medicare and Medicaid Services annually evaluate and adjust costs based on a variety of factors such as inflation, medical costs, claims, and more. Three significant factors contributing to these changes in 2022 were rising health care costs (compounded by COVID-19), previously planned premium increases that were limited due to the pandemic, and the reservation of Medicare funds in anticipation of covering the new Alzheimer’s drug Aduhelm.
Here, we’ve broken down some of the more significant cost changes that took place in 2022 and what you can reasonably expect for 2023.
| 2022 | 2021 | |
|---|---|---|
| Part A – Monthly Premium | $0 for most participants. For those that pay a premium for Part A, the cost will be either $274 or $499 (depending on how long you or your spouse worked and paid Medicare taxes for) | $0 for most participants. For those that pay a premium for Part A, the cost will be either $259 or $471 (depending on how long you or your spouse worked and paid Medicare taxes for) |
| Part A – Inpatient Hospital Stay Deductible and Coinsurance | $1,556 deductible (per benefit period) While the coinsurance after the deductible is still $0 for the first 60 days,
| $1,484 deductible (per benefit period)
|
| Part A – Skilled Nursing Facility Stay |
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| Part B – Monthly Premium | Base premium amount of $170.10 (may be higher depending on income and/or penalties due to late enrollment) | Base premium amount of $148.50 (may be higher depending on income and/or penalties due to late enrollment) |
| Part B – Deductible | $233 to be paid before Medicare begins to pay | $203 to be paid before Medicare begins to pay |
What’s anticipated for 2023 and beyond
According to a recent announcement from The Centers for Medicare and Medicaid Services, a slight decrease in Part D monthly premiums is anticipated, from $32.08 to approximately $31.50. This is based on plan bids submitted by Part D providers. It is expected that Medicare will also continue to focus on expanding the availability of telehealth, including mental and behaviorial health services both virtually and over the phone. Further affecting participants of Medicare is the proposed Inflation Reduction Act of 2022 which will limit out-of-pocket drug costs to $2,000 per year (beginning 2025), insulin to $35 per month, and make most vaccines available at no charge (January 2023). The legislation will also allow Medicare to negotiate the costs of certain drugs in 2023, beginning with ten high-cost prescription drugs and gradually increasing to 60 over 6 years. This is expected to save Medicare hundreds of billions of dollars over 10 years.
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