AHCP Blog

Medicare Premiums and Cost Sharing for 2023

Written by AHCP | 10/14/22 2:19 AM

CMS has released the Medicare premium and cost sharing numbers for 2023, and it’s much better news than we received last year. For 2022, the standard Medicare Part B premium went up by more than $20 per month. For 2023, it’s actually going down a little. Finally, some good news!

Medicare Part B Premium

According to a September 27 CMS Fact Sheet, “the standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022.” 

As we explained in a July 15, 2022 blog post, this decrease was anticipated and was a result of a price reduction for the new Alzheimer’s drug Aduhelm. About half of the 2022 Part B premium increase was in anticipation of this drug hitting the market, but when the manufacturer cut its average price in half, from $56,000 to $28,200, CMS made the decision to adjust the 2023 Part B premium.

The premium people pay for Medicare Part B is actually based on their income two years prior, so the 2023 premiums will be determined by what beneficiaries earned in 2021. The chart below, also included in the CMS fact sheet, shows the standard Part B premium for 2023 as well as the premiums for those who must pay the Income-Related Medicare Adjustment Amount, or IRMAA:

Medicare beneficiaries who have had a change in family status (death of spouse, marriage, or divorce) or work status (work reduction or stoppage), or who have had a loss or reduction of income (from income-producing property or pensions), can request a reconsideration of the IRMAA determination by contacting the Social Security administration. We provide more information in a July, 2022 blog post: https://learn.ahcpsales.com/blog/appealing-an-income-related-medicare-adjustment 

Medicare Part D Premium

The same Medicare beneficiaries who must pay more than the standard amount for the Part B premium must pay an additional amount for Medicare Part D as well. The Part D premium is also based on your income two years ago.

Medicare Cost Sharing

The annual Part B deductible is also decreasing to $226; that’s $7 less than in 2022.

For Medicare Part A, beneficiaries have a benefit period deductible instead of a calendar-year deductible. That means it can actually hit multiple times in a single year.

For 2023, the Part A deductible is a nice, round number: $1,600. In fact, Medicare has done the same with its copay amounts: $400 per day in the hospital after day 60 and $800 per day in the hospital after day 90, during the beneficiary’s lifetime reserve days. The Part A cost-sharing amounts for 2022 and 2023 are shown in the chart below.

Annual Election Period

The annual election period for Medicare Advantage and Medicare Part D prescription drug plans begins October 15, so the timing of this announcement is good. As we said, you finally have some good news to share with your clients. (Click here for tips on sharing important information with your Medicare clients.)

If you’re looking for additional solutions for your Medicare clients and prospects, be sure to visit the Medicare page of our website. AHCP partners with a number of carriers that offer Medicare Advantage plans, Medicare Part D plans, and other solutions that can benefit your Medicare-eligible clientele.