Our goal is always to help you find the best value in Medicare coverage.
Many changes are coming to Medicare in 2023 that may affect your coverage and your costs.
Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To…
In this video, we’re taking a look at the Medicare changes for 2023 so you’ll know how these changes will affect you and be prepared for the Annual Enrollment Period between October 15 and December 7 when you’ll see these changes implemented in the 2023 Medicare Advantage and Part D plans in your area.
By the end of this video, you’ll know how the changes to Medicare in 2023 that have been announced already will affect you and, just as important, I’ll tell you what to watch for in future months as even more 2023 Medicare rules and costs are released.
Medicare Enrollment Period Changes in 2023
Medicare Initial Enrollment Period Changes
There’s good news for anyone who will be enrolling in Medicare in 2023!
For most people, the first time you’re eligible to enroll in Medicare is during your Initial Enrollment Period, which is a 7 month window surrounding your 65th birthday: three months before your birth month, your birth month, and three months after your birth month.
Through the end of 2022, if you apply for Medicare before the month in which you turn 65, your coverage starts the first day of the month in which you turn 65. If you wait to enroll until the month of your 65th birthday, your coverage will start the next month.
But what happens if you wait to enroll until months 6 or 7 of your Initial Enrollment Period?
As the system is set up now, you do not have coverage starting the month after you apply. You have a penalty delay of coverage built in.
Starting in 2023, that delay is going away. So if you wait to enroll in Medicare until those final months of your Initial Enrollment Period, your coverage will start the first day of the month after you apply. No more delay in coverage.
Medicare General Enrollment Period Changes
This enrollment period doesn’t affect many people. This is for anyone who missed their entire Initial Enrollment Period, which doesn’t happen that often.
But if you miss your Initial Enrollment Period and want to enroll in Medicare later, you have to enroll during the General Enrollment Period. Here’s how that works right now.
You enroll in Medicare between January 1 and March 31. Then your Medicare coverage starts on July 1.
That coverage delay is also going away. Starting in 2023, the General Enrollment Period will still be January 1 through March 31, but your coverage will start the first day of the month after you apply.
If you did not have creditable health coverage and waited until the General Enrollment Period to apply for Medicare, you may have late enrollment penalties, but you don’t have to wait months and months for your coverage to start.
There are also some new Special Enrollment Periods that are being created in 2023 for people affected by exceptional circumstances. Here is a link to more information on those.
Medicare Enrollment Due to Disability Before Age 65
If you are eligible for Medicare due to a disability before age 65, your situation is different. Please see the video linked here for more information on your enrollment periods.
Changes in Medicare Part D Vaccine Costs to You in 2023
Medicare vaccine coverage is a bit confusing. Some vaccines are covered by Medicare Part B and others are covered under Medicare Part D.
For the vaccines covered by Part D, currently you run those charges through your Medicare Part D insurance. If you have a deductible to pay for the year or a copay or coinsurance for the vaccine, you have to pay that.
Beginning in 2023, there will be no cost sharing for adult vaccines covered under Medicare Part D. That means your Part D covered vaccines will cost you nothing out of pocket.
For this benefit you do have to have Medicare Part D coverage. If you decided not to take Part D, then you can’t take advantage of this vaccine benefit unless you enroll in a Part D plan.
The most common vaccine this change will affect is the shingles vaccine. On most Part D plans the shingles vaccine has a significant copay, so this change will be a savings for anyone getting the shingles vaccine.
Insulin Cost Sharing Limit of $35 per Month
There’s already a program that some Part D plans participate in that limits your copays on insulin to $35 per prescription per month.
Beginning in 2023, that will be expanded to every Part D plan and insulin covered under Medicare Part B. That means whether you use syringes or an insulin pump, you will have that $35 per insulin prescription per month cost sharing.
Medicare Part D 2023 Projected Basic Part D Average Premium
The basic Part D average premium is not necessarily the premium you pay to have Part D coverage. This number is released every year by CMS to give Medicare beneficiaries a very rough guide to the direction Part D are going in the new plan year.
In 2022, the basic Part D average premium was $32.08. The 2023 basic average premium is $31.50. That’s a slight decrease that may be reflected in your plan options for Part D coverage in 2023, but doesn’t mean your current Part D plan is going to lower its premium.
This number does affect those who have to pay the Part D late enrollment penalty. For more information on how that penalty is calculated, please see the video linked here.
Medicare Insurance Plan Broker/Agent Communication Changes
Two big changes are coming October 1, 2022 that will carry into 2023 regarding your communication with your Medicare plan agent or broker.
The first change is that all phone calls between you and your Medicare plan broker that discuss Medicare Advantage plans or Medicare Part D coverage will have to be recorded and kept on file for 10 years.
The larger call centers for Medicare plans have already had to do this for years. Starting October 1, that rule is being expanded to independent agents and brokers also.
The other change is that an extra disclaimer will need to be said verbally in the first 60 seconds of any phone call and it must appear on all websites and written communication.
Here is the disclaimer: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”
That disclaimer wording is a little odd, so I want to clarify a few things.
First, medicare.gov is one of the tools we use when comparison shopping with you. Also, the other tools we use to compare Medicare plans allow us to show all the plans that exist in your area, not just our contracted plans, so we’re never hiding any available plans from you.
We contract with most Medicare plans. There are some insurance companies that don’t sell their plans through independent agents, so we can’t be contracted with those.
When the best plan for a Medicare beneficiary is one that we don’t contract with, we tell the beneficiary that. Honesty is the best way to stay in business for over 45 years.
Medicare 2023 Changes Still to Come…
The big change to watch for is the 2023 Medicare Part B monthly premium. Between 2021 and 2022, Medicare Part B had its biggest premium increase in history.
A lot of that increase was due to a new very expensive Alzheimer’s medication that has since not lived up to expectations.
Will CMS decrease the Part B premium for 2023? Keep it the same?
No one knows yet. Here is a link to the most recent press release on Part B premiums, but don’t expect the final numbers to be released for a few months at least.
Other 2023 Medicare information to watch for includes: IRMAA – the income related monthly adjustment amount for high income Medicare beneficiaries; and Medicare Parts A and B deductibles, copays, and coinsurance.
One of the most important for you: specific plan changes to your current coverage. This is information you will receive in the next six weeks or so in your Annual Notice of Change (ANOC) document. This will tell you how your Medicare Advantage or Part D plan is changing for 2023.
If any of those changes will negatively affect you, you will definitely want to compare your current plan to others in your zip code during the Annual Enrollment Period between October 15 and December 7.
Have Questions? We Can Help!
For answers to your specific Medicare questions and to objectively compare all available Medicare plans where you live, please feel free to call our office at 877-312-1414 or schedule a free, no obligation Medicare plan consultation.
Our services are always free and enrolling through our office does not increase the cost of any insurance.
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