Medicare premiums and deductibles for 2023

[Nikki J]

2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts | CMS

On September 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2023 Medicare Part D income-related monthly adjustment amounts. Medicare Part B Premium and Deductible

www.cms.gov

the part b decreased slightly as did the part b deductible. Part a deductible increased slightly. The IRMAA adjustments if they apply to you are a little better too. If you remember last year part b premiums jumped due in large part to expected costs from Aduhelm that did not materialize

 

[KimT]

Nikki, I've been following this like a hawk holding my breath. I got notice that my Part D premium decreased but, upon further inspection, I can see why. Some of my meds were reclassified. I'll be comparing Part D policies but, in all likelihood, I'll be getting one drug from Canada and another from GoodRX.

I try to help the old people in my condo navigate changes. My SIL is lost. She will need guidance because her friends are trying to convince her to change to an Advantage plan and, in our zip code, we don't have Advantage plans that fit her needs.

 

[Nikki J]

Picking part d is going to be tricky if amx0035 is approved. It probably isn’t going to get on many if any formularies for regular part d but the timing is such that we likely can’t know in time to pick. I will be asking again but if it turns up covered for anyone with part d ( so not employer, VA or advantage) can you please share your plan. And if anyone is getting radicava ors with straight part d I am interested in that information too

 

[Nikki J]

And social security is going to increase 8.7% next year

 

[KimT]

My phone has been ringing off the hook with questions. I try to help where I can but all the Advantage commercials on TV are enticing our older residents, who have more than enough money to stay on Supplement F and shop around for their Plan D, have been asking why they can't switch to Advantage. I try to explain how different an Advantage Plan in Florida is from an Advantage Plan in California, but when they hear zero premium and free dental exams, the want to switch. These are people in their 70s, 80s, and even 90s who have pre-existing conditions and are used to going to Mayo for serious issues.

It doesn't help that we have a lady selling Advantage Plans in our condo. She held a "seminar"

I'm still holding my breath on my Florida Blue Supplement. Right now it's about $175 a month and, since I've had it, it only goes up about 1-2% per year. Last year it didn't increase. I was so lucky to get a second open enrollment when I turned 65 because, in Florida, my premium was $600 a month before 65. Some other States don't separate disabled from people over 65. Others do.

 

[Nikki J]

Hopefully your blue won’t be too bad. Mine ( MA) was only up a couple of dollars a month. So far so good but waiting on d until the last week or so to see if anything positive develops for relyvrio not optimistic though. I don’t see how even covered it can be affordable with the current medicare d rules

 

[KimT]

It's very sad when most of us can't afford things that might help.

 

[old dog]

I've had a variety of Advantage plans since I retired in 2005. Initially, I didn't really understand how they worked. When they were a new thing, the companies selling them were very careful to avoid disclosing that the money withheld from a person's SS check for Medicare went to them, weakening the Medicare program and gradually privatizing it. The things advertised in the Advantage Plan commercials are often not available in a person's zip code. The benefits described are usually found only in densely populated areas where there are highly rated medical practitioners and relatively healthy residents.

I have not been able to afford a Medicare Supplement so have stuck with an Advantage Plan that caps out-of-pocket expenses. I'm aware that I'm playing Russian Roulette because the private insurance carriers can raise the cap amount (they have for 2023) or eliminate it entirely. Advantage Plans require referrals to see a specialist of any kind. In my area, there are very few dentists that accept my plan because payment rates are so low. My advice is to avoid Medicare Advantage Plans and keep Original Medicare and a Supplement if your finances permit. It is very difficult to get back on Original Medicare once you have chosen to go to an Advantage Plan. Another thing happening in my area is some providers are refusing to take patients who have Original Medicare because payment rates are so low.

Choosing the best coverage for an individual is a complicated process. What works for one person may not work at all for another.

 

[lynnbr2]

Caveat emptor - CMS does not admit wrongdoing.

CMS to release Medicare Advantage audits in response to lawsuit

CMS will release 90 audits of Medicare Advantage plans accused of overcharging the government in response to a lawsuit from Kaiser Health News, the outlet said.

www.beckerspayer.com

 

[KimT]

For those following this thread. Remember, if you are under 65 and disabled, you will get two open enrollments. One when you first go on Medicare, then another when you turn 65. I chose a Medigap supplement when I went on disability at 60. By the time I was 65 the premium was $600 a month. When I turned 65, I had another open enrollment and the same plan went down to $170.

Yes, it all depends on your zip code AND the state in which you reside. In New York, they average in all the disabled with the over 65 so the initial hit for disabled people under 65 isn't so high.

The Affordable Care Act made it illegal to charge more than 3X the regular rate for those under 65. Before that it was horrible. It's still bad and we need to fight for more changes.

 

[lgelb]

Not all Advantage plans require referrals for specialists. That would often be true if they are an HMO design. Many are PPO designs. Some allow for out of network coverage at a lesser rate and some don't.

Either way, it is wise to check out exactly what providers are in network before signing up.

 

[Nikki J]

It so much depends where you live Massachusetts has never had a PPO MA but they are going to have one next year. However its network is quite small- significantly smaller than the regular HMO run by the same company. I had that HMO before medicare and they were great so make sure you are looking at the correct listing if you are considering an MA plan Also try to verify with your doctors’ offices specifying the plan is the MA one