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You Will Pay Less for Medicare Part B in 2023 and Some Prescription Drug Coverage Changes Starting in 2023

MEDICARE PART B PREMIUM DECREASE — As speculated here a few months back, The Centers for Medicare & Medicaid Services (CMS) recently announced that the 2023 Medicare Part B rate will actually drop from $170.10 to $164.90 per monthPart B premiums decrease by 3% or $5.20 per month in 2023 marking the first Part B rate decrease in over 10 years.  The decrease serves to offset a portion of last year’s higher than normal rate adjustment.

Also, 2023 Medicare Deductible Amounts and Part B and Part D Income-Related Monthly Adjustments Amounts (IRMAA) were announced.  We’ll post that information soon under the News heading on our website and address the ramifications in our next newsletter.  You can always email me with your questions or if you’d like to receive the IRMAA information right away.

SIGNIFICANT CHANGES TO MEDICARE PRESCRIPTION DRUG COVERAGE STARTING IN 2023 — The signing of the Inflation Reduction Act in August signaled the beginning of several years of what I think are some substantial changes for the better to Medicare Prescription Drug Coverage (Part D).   The two most imminent changes, which take effect January 1, 2023, include:

  • $35 insulin copay maximum. The member copay or out-of-pocket cost on covered insulins is capped at $35 per month.  This means that anyone covered by Medicare and enrolled in prescription drug coverage (stand-alone PDP or Medicare Advantage) won’t pay more than $35 for a one-month supply of each insulin product covered by their plan, no matter what cost-sharing tier it’s on and even if their plan has a deductible that hasn’t been met.  Depending on their plan, some beneficiaries could pay even less.  Some plans have already taken steps to introduce a $0 copay for some types of insulin in 2023.
  • $0 Vaccines. Cost sharing (copays and or coinsurance) for adult vaccines covered under Medicare Part D Prescription Drug Coverage (stand-alone PDP and Medicare Advantage) has been eliminated.  In other words, beginning in 2023 prescription drug plans will cover most vaccines for $0 cost-share, even if a plan’s deductible has not been met.

Other prescription drug changes having a positive impact on Medicare beneficiaries over the next few years include:

  • Eliminating the catastrophic phase caps out-of-pocket Rx costs in 2024. In 2024, the 5% coinsurance for catastrophic coverage in Medicare Part D drops to 0%.  This effectively eliminates the catastrophic phase and caps out-of-pocket costs after the coverage gap benefiting those who rely on the most expensive medications.
  • Starting in 2025 Maximum Out-of-Pocket Prescription Drugs Costs are capped at $2,000 per year for all Medicare Prescription Drug Coverage — all stand-alone Part D Plans, and all Medicare Advantage Plans.

Further Discussion

If there are specific topics you’d like us to address in future issues, please drop Tom a line at tbarrett@bbginc.net with your suggestions.