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As always September is the month for all Medicare updates, plans, premiums, adjustments etc. Two days ago, Medicare and Medicaid services released the latest. 

As a Medicare recipient you know that Medicare Part A covers hospital stays, skilled nursing, hospice care and Medicare Part B covers what is medically necessary such as your doctor visits, hospital stays, Part B drugs, durable medical equipment, outpatient procedures and some home health care services. 

medicare part b

Part B Deductible & Premium

The Social Security act determines each year what the Part B deductible, coinsurance and Part B premium will be for the new year.

This coming year for 2023 we were informed that the Part B premium will be reduced from $170 down to $164.90. Also, the Part B deductible will be reduced from $233 down to $226. 

Under Original Medicare if you are admitted into a hospital the deductible will be $1,600 for 2023. That deductible is for your first 60 days of your stay.

Between the 61st day to the 90th day there is a coinsurance amount of $400 for each of those days.

Your lifetime reserve days in the hospital has increased to $800 per day in 2023 from $778 per day in 2022. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200.00 in 2023 ($194.50 in 2022).

A few months back I wrote about a drug called Aduhelm which was in its clinical trial phase. Aduhelm from what the research shows is that it does reduce levels of amyloid beta plaque in Alzheimer patients. Many other drugs in past trials have failed to do this. A decision was made for Medicare to cover this drug for Medicare patients only during its clinical trial.

During this time the spending on Aduhelm and some other Part B services was much lower than originally planned.

In result it created a larger reserve in the Part B account which may benefit Medicare recipients in the future by limiting Part B increases. Aduhelm has not yet been given the green light, but the future does look promising for the coverage of the drug under Medicare. 

Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium.

For 2023, the immunosuppressive drug premium is $97.10.

With all that said, as always, the Medicare Annual Enrollment Period (AEP) starts October 15th and runs to the deadline December 7th. During AEP you can decide to switch from Original Medicare to a Medicare Advantage plan or vice versa.

If you are already on a Medicare Advantage plan you can review the other Advantage plans in your area and join other plans.

I know during this time a lot of my efforts are taken up with reviewing Part D prescription drug coverage for my clients. During AEP you can change your Part D plan to another. It is always smart to review this coverage every year because monthly premiums, deductibles, co-pays and formularies change.

It could mean a lot of money out of you pocket by ignoring these changes.

For instance, the Part D Plan Elixir is going from $20 per month to $60 per month in 2023. 

IRMAA

 

Full Part B Coverage
Beneficiaries who file individual tax returns with modified adjusted gross income:Beneficiaries who file joint tax returns with modified adjusted gross income:Income-Related Monthly Adjustment AmountTotal Monthly

 Premium Amount

Less than or equal to $97,000Less than or equal to $194,000$0.00$164.90
Greater than $97,000 and less than or equal to $123,000Greater than $194,000 and less than or equal to $246,000$65.90$230.80
Greater than $123,000 and less than or equal to $153,000Greater than $246,000 and less than or equal to $306,000$164.80$329.70
Greater than $153,000 and less than or equal to $183,000Greater than $306,000 and less than or equal to $366,000$263.70$428.60
Greater than $183,000 and less than $500,000Greater than $366,000 and less than $750,000$362.60$527.50
Greater than or equal to $500,000Greater than or equal to $750,000$395.60$560.50

 

Something that comes up a lot especially with a large percentage of my clients is a term called IRMAA, which is the Medicare Part B Income-Related Monthly Adjustment Amounts. This Part B premium is based on your income.

The number of $164 for the Part B premium I spoke about earlier does not apply for all. In fact, about 7% of Medicare recipients will pay more. 

This coming year for 2023 we were informed that the Part B premium will be reduced from $170 down to $164.90. Also, the Part B deductible will be reduced from $233 down to $226. 

Most people I assist with their Medicare options do not know about IRMAA at all and most are surprised when they are hit with it. I urge you to speak with Social Security when signing up for Part B so you can figure out how it will affect you. Or you can simply review the Part B outline above.

This is very important to know so we can include it in your medical spending when reviewing your options. 

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