Deductibles decrease

For 2023, the Part B annual deductible decreased to $226, a decrease of $7 compared to 2022 and this is the first decrease in a decade.

Annual deductibles for Medicare Advantage and stand-alone Part D prescription drug plans vary depending on the plan you choose and where you live. The government sets a limit for Part D deductibles, for this year this limit is $505, compared to $480 in 2022. 

Part A costs increase

The fixed Medicare cost that is increasing is the Part A deductible. Although most Medicare beneficiaries do not pay a monthly premium for Part A, which covers hospital services, skilled nursing facilities, hospice care and some home health services, there is a hospital deductible.

For this year, this deductible will be $1,600 per stay, an increase of $44 from the 2022 deductible. Monthly premiums will also increase for those who have not worked enough to qualify for free Part A benefits. In 2023, the full Part A premium will be $506 per month, an increase from $7. Whether a beneficiary must pay the full Part A premium depends on his or her work history or spouse. Beneficiaries with a Medicare Advantage plan should consult their plan to determine hospital costs.

 Insulin co-payments were limited

Under the Inflation Reduction Act of 2022, which includes several provisions that reduce prescription drug prices for Medicare beneficiaries, beginning in 2023, a 30-day supply of any type of insulin covered by a Medicare prescription drug plan is capped at $35. Even beneficiaries have yet to meet their annual Part D deductible, nor do they have to pay more than $35. Remember that not all plans cover all types of insulin.

Beginning July 1, Medicare beneficiaries who receive insulin by pump as part of Part B long-term medical device benefits will not have to pay a deductible and will also benefit from a $35 limit.

Another provision of the new law stipulates that certain expensive drugs must be negotiated with drug manufacturers. So, while the maximum monthly copayment for Medicare-covered insulin is $35 in 2023, 2024 and 2025, beginning in 2026, the first year the negotiated price goes into effect, any insulin that is part of the new negotiations, the covered deductible will be $35 or 25 % of the negotiated price, whichever is less.

 In our next blog we will address other Medicare changes coming this year.

If you need help with Medicare or health plans, call us for free advice. Our local number is 512-520-5957 or you can call us on our toll free number which is 855-GO-AVILA. We are here to serve you.