7 of the Biggest Changes for Medicare in 2023

Each year, Medicare evolves with new benefits, different rules and regulations, and premium adjustments. We are committed to helping you stay up-to-date on how Medicare will affect you in 2023! Here are the top 7 changes for Medicare this year.

1. Your Medicare premiums and deductibles decreased.

Each year, Medicare Parts A and B have slight changes to their premiums and deductibles. Typically, they go up, and last year, they went up more than ever before.

However, you're finally getting a break as Medicare Part B's premium actually decreased! The Medicare Part B premium for 2023 went down by $5.20 to $164.90.

The Part B deductible also decreased slightly by $7 to $226.

Most people with Part A's hospital coverage do not pay a premium. The Part A deductible did go up to $1,600. However, if you have a Medicare Supplement plan, this deductible will most likely be covered in full.

Related: How Income Affects Your Medicare Costs In 2023

2. Hemgenix, a $3.5 million drug, has been approved.

New prescription drugs are coming onto the market constantly, and the prices are more staggering with each passing day.

Last year, Aduhelm (a new, controversial Alzheimer's treatment) had the spotlight as it originally came onto the market with a $56,000 per year price tag. Biogen, the manufacturer of Aduhelm, ended up slashing the price in half to $28,200 per year, but that expense is still a potential burden to the Medicare system.

This year, Hemgenix is taking the spotlight with its $3.5 million price tag. Hemgenix is a one-time gene therapy infusion for adults with hemophilia B, and it was approved by the FDA in late 2022.

The multi-million dollar price tag comes with serious sticker shock, but proponents of the therapy say it could actually be a cost savings. Those with severe or moderately severe hemophilia B should expect to pay upwards of $20 million throughout their life for treating and managing their condition. In comparison, Hemgenix would cost $3.5 million to potentially avoid future treatments.

We don't know yet how this will impact the Medicare system or your Medicare premiums. We'll continue to follow this story and will post updates in our weekly email newsletter and our Facebook page.

3. Insulin costs are now capped until 2025.

The Inflation Reduction Act (IRA) is relatively new legislation that is rolling out changes to the Medicare Part D program over the next few years.

In 2023, one of the perks is a $35/month copayment cap on insulin prescriptions for those with Medicare Part D. This cost savings will stay in place until 2025.

If you have any questions about your insulin costs or Part D plan, don't hestiate to reach out to our office for help!

4. The shingles vaccine is now free.

The shingles vaccine has been a significant expense for many individuals as it historically has not been fully covered by Medicare.

However, another nice result of the IRA legislation is the shingles vaccine is now free. In fact, all CDC-recommended vaccines will be no cost to Medicare users.

5. Medicare coverage starts sooner for new enrollees.

If you're already enrolled in Medicare, this change will not have any impact on you this year. However, if you're getting ready to sign up for Medicare, your coverage will start even sooner than before.

Starting January 1, 2023, your Medicare Part B coverage starts the first day of the month after you sign up if you sign up during the last three months of your IEP. Before this announcement, if signing up for Medicare Part B during the last three months of your IEP, your coverage didn’t start until two to three months after you enrolled.

As an example, let's say you turn 65 in July. You can sign up for Medicare during a 7-month window that starts in April and ends in October. If you sign up for Medicare in August, your coverage would begin September 1st. In the past, your coverage might not become effective until October or November. This is a nice adjustment!

6. You may now be able to get a covered lung cancer screening.

In 2023, Medicare Part B will now cover a lung cancer screening if you meet some eligibility criteria.

• You’re 50–77 years old
• You don’t show signs or symptoms of lung cancer  
• You currently smoke or have quit in the last 15 years
• You have a tobacco smoking history of at least 20 pack years (meaning you’ve had on average 20 cigarettes/one pack a day for at least 20 years)
• You get an order from your doctor

If this fits your profile, ask your doctor about getting that covered screening!

7. Part D drug price negotiations begin in September.

Another big change coming in 2023 is that Medicare will begin negotiating the price of 10 drugs. They'll select these 10 drugs and publish the list on September 1, 2023. These 10 drugs should be the ones that cost the Medicare program the most money.

Experts estimate this type of drug negotiation would have saved the Medicare program over $26 billion if it were in effect from 2018-2020. Hopefully, Part D costs will decrease for everyone with a prescription drug plan.

Conclusion

The Medicare program is constantly changing – sometimes for the better, and sometimes for the worse. This year, we feel many of the changes are positive and will improve your experience with Medicare.

We'll continue to keep you updated on how Hemgenix may impact your Medicare Part D costs, but for now, there's nothing to do but wait. If you're not already, subscribe to our weekly email newsletter and like our Facebook page to stay informed on all things Medicare.