Wed. Jun 19th, 2024

Your medical needs change every year, and so does your Medicare coverage. Medicare coverage will also adjust as the economy changes, medical industry trends emerge, and policy changes occur. It is essential to ensure that you have the best coverage for your needs heading into 2023.

All Medicare recipients should review their coverage and health plan options before December 7th, 2022, to receive the most cost-effective coverage in 2023. But there are a few things you need to know about health insurance in 2023. 

The fall enrollment is a time to change

The Fall Open Enrollment for specific Medicare plans is from October 15th until December 7th each year. This enrollment period allows Medicare beneficiaries to change their existing Part D or Medicare Advantage plans.

The sooner you register for proper coverage, means any last-minute changes can be made on time without running the risk of missing an opportunity. Medicare plans can change their offerings and prices before the new year, so make sure you register for a 2023 plan during the Annual Election Period to get the right one for you.

However, if you are transitioning to Medicare at 65 from other coverage such as ACA insurance, you will want to learn more about your enrollment here: boomerbenefits.com/can-i-choose-an-aca-plan-over-medicare/.

Part D Insulin Coverage

Beginning January 1st, 2023, Part D insulin coverage will place a cap on monthly insulin supply at $35. This means if you use traditional insulin without a pump, insulin used with a disposable pump, or other injectable insulin covered by your Part D plan, there will be a monthly cap. 

Additionally, if you use insulin with traditional insulin pumps, generally covered by Part B Medicare, similar caps will apply beginning July 1st, 2023. Although some plans in 2022 offered a cap on insulin, not every plan did. This new change forces all Part D and Advantage plans with drug coverage to include this cap on injectable insulin. This significant financial change can help beneficiaries save greatly on their necessary medications.

Inflation Reduction Act

In addition to lower insulin prices, Medicare recipients will now see zero out-of-pocket costs for vaccines recommended by the Advisory Committee on Immunization Processes (ACIP), thanks to the Inflation Reduction Act

Medicare recipients will no longer pay any costs associated with certain vaccines found on their plan’s formulary, including the Shingles vaccine and Tetanus-Diptheria-Whooping Cough vaccine. Before 2023, most beneficiaries had to meet their plan’s deductible before it kicked in to help pay some of the cost.

Medicare & Coronavirus

Medicare beneficiaries can receive the newest COVID-19 vaccines with no out-of-pocket costs. The updated vaccine covers the original COVID-19 strain, as well as 2 Omicron viral variants: BA.4 and BA.5. Medicare covers the cost for anyone over the age of 65 or who has a disability, ALS (a.k.a. Lou Gehrig’s Disease), or End-Stage Renal Disease (ESRD). 

If you are immunocompromised, Medicare will also cover the cost of another COVID-19 vaccine 28 days after your original second dose.  

Consolidated Appropriations Act of 2021

Another meaningful change you will want to know about for 2023 is the Consolidated Appropriations Act of 2021. What this means for new enrollees is when you enroll in Medicare during your Initial Enrollment Period, your coverage will not be delayed if you apply during the three months after your birthday month. Additionally, if you apply during the General Enrollment Period, your benefits will begin on the 1st of the following month. 

These new changes will help prevent long gaps in coverage for many beneficiaries!

In Summary

Everyone’s needs change yearly, and their insurance coverage should change too. It’s important to stay up to date with all the Medicare changes to be prepared for the new year!

By Manali