Understanding Upcoming Changes to Medicare in 2023

By Brian Krantz - February 22, 2023

As we move into a new year, there are several upcoming changes to Medicare that beneficiaries need to be aware of. In this article, we will provide a comprehensive overview of the changes and how they may impact you.

Medicare is a government-funded healthcare program that provides coverage to millions of Americans aged 65 and older, as well as those with certain disabilities. The program is designed to provide access to medical services, hospital stays, and prescription drugs. Medicare is constantly evolving, and there are several changes that are coming up in 2023 that you should be aware of.

Changes to Medicare Advantage Plans

One of the most significant changes coming up is the expansion of Medicare Advantage plans. Medicare Advantage plans are a type of health plan offered by private companies that contract with Medicare. These plans provide all the benefits of traditional Medicare, and often offer additional benefits such as vision, dental, and hearing coverage. In 2023, there will be new rules allowing insurers to offer more customized benefits, such as transportation to medical appointments, meals, and even home-delivered groceries.

Increased Coverage for Telehealth Services

Another significant change coming up is the expansion of telehealth services coverage. Telehealth services allow beneficiaries to receive medical care remotely, from the comfort of their own homes. This can be particularly useful for those who have difficulty accessing medical care due to distance or mobility issues. In 2023, Medicare will be covering more telehealth services, including mental health services, and the copayments for these services will be waived.

Prescription Drug Costs

Prescription drug costs are a significant concern for many Medicare beneficiaries, and there are changes coming up that will impact the coverage and cost of prescription drugs. In 2023, the Part D standard deductible will increase from $480 to $505. The monthly premiums for the standard Medicare Part D coverage will go down from $32.08 in 2022 to $31.50 in 2023, meaning the premiums for your plans will be lower. Additionally, the coverage gap (commonly known as the “donut hole”) for Medicare Part D will begin once you and your plan have spent $4,660 on covered drugs in 2023. Once you hit the coverage gap, you’ll pay no more than 25% of the cost for your plans covered brand-name prescription drugs.

Insulin Co-Pays Capped

In 2023, the cost-sharing for insulin will be capped at $35 per month, making it more affordable for beneficiaries who need insulin to manage their diabetes.

Free Vaccines

Medicare beneficiaries will have access to free vaccines, including the COVID-19 vaccine, as well as vaccines for other diseases such as the flu and pneumonia. The hepatitis B vaccine will now be covered under Medicare Part B for beneficiaries with limited income. Additionally, some vaccines needed to treat certain injuries or if you have direct exposure to a disease, including hepatitis A, rabies, and tetanus, will be covered under Medicare. The shingles vaccine, previously covered under Part D, will now be covered under Medicare Part B. This vaccine is used to prevent shingles, a painful and potentially debilitating condition.

Increased Emphasis on Behavioral Health

In 2023, there will be an increased emphasis on behavioral health. Medicare will be expanding coverage for mental health services, including therapy and counseling, to help beneficiaries access the care they need.

Access to Medically Necessary Dental Services

Beginning in 2023, Medicare will cover medically necessary dental services that will improve the outcome of an organ transplant or cancer treatment. This includes dental work that will improve the outcome of an organ transplant or cancer treatment, such as a tooth extraction before undergoing chemotherapy.

When Your Coverage Starts for Medicare 2023

It’s important to know when your Medicare coverage will begin, especially if you are turning 65 or signing up for Medicare for the first time in 2023. If you sign up for Medicare the month after you turn 65 or three months after you turn 65, your coverage will start the first of the following month. For example, if your 65th birthday is on May 15, 2023, and you sign up for Medicare in June, your coverage will start on July 1, 2023.

If you sign up during the General Enrollment Period, which is from January 1 to March 31 each year, your coverage will also start the first of the following month. However, in the past, coverage did not start until July 1 even if you signed up during the General Enrollment Period. Starting in 2023, coverage will start the first of the following month. This means that if you sign up for Medicare during the General Enrollment Period in 2023, your coverage will start on the first of the following month.

It’s important to note that if you have delayed enrolling in Medicare and sign up during the General Enrollment Period, your coverage will be delayed and you may have to pay a late enrollment penalty. Make sure to stay informed about enrollment deadlines and any changes to Medicare coverage to ensure you have the coverage you need when you need it.

In conclusion, the upcoming changes to Medicare in 2023 will have a significant impact on beneficiaries, with expanded access to healthcare services, more affordable prescription drug costs, and more comprehensive coverage for dental and other medical procedures. The expansion of telehealth services, the increased emphasis on behavioral health, and the coverage of free vaccines will all help to improve the overall healthcare experience for beneficiaries. It’s important to stay informed and up-to-date with any changes to your Medicare coverage to ensure that you are receiving the best possible care. Working with a Plan Medicare agent will ensure that all of your Medicare questions are answered and you are staying up to date. Call now to speak with a local New York Medicare agent, 516-900-7877 


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