There are significant changes to Medicare starting in 2023. Most are the result of typical pricing changes that occur annually, but the Inflation Reductions Act components aim to lower prescription costs. Medicare Part B premium is falling while some Medicare premium and deductible amounts will increase.
The changes that will have the most impact on Medicare beneficiaries will be the decrease in Part B premium, the cost reductions on insulin, and the increase in the deductibles.
Medicare Part B Costs
Medicare Part B covers outpatient and medical provider services.
Medicare Part B enrollees faced one of the most significant premium increases ever between 2021 and 2022. The increase was related to the cost of a medication that had its cost slashed after 2022 Medicare prices were announced. In 2023, Medicare program managers will lower the Part B premium.
Medicare Part B out-of-pocket cost rules work differently than Medicare Part A cost-sharing requirements.
This program will have a small annual deductible in 2023. Once this deductible is satisfied, the beneficiary is responsible for 20% of the Medicare-approved amount and any applicable excess charges.
The Inflation Reduction Act
The new Inflation Reduction Act (IRA) will affect drug prices in 2023.
One portion that begins early is a provision limiting insulin costs to $35 for a monthly supply of insulin, whether the insulin is covered by Medicare Part B or Medicare Part D.
The IRA also removed a non-interference provision that made it illegal for the federal government to negotiate drug costs.
Starting in 2023, Medicare program managers can negotiate the price of 10 of the most costly Medicare-covered drugs.
For a drug to be subject to price negotiations, it must have no competitors, and it must have been on the FDA’s approved list for a minimum of nine years.
Knowing the changes that are taking place in 2023 will help our clients make educated choices about coverage options. You can count on us to help you understand your options. Call us toll free at (866) 235-8378 or click here to email us your name and phone number for us to call you.
On August 16, 2022, the Inflation Reduction Act was signed into law. In 2023, the law requires pharmaceutical companies to pay a fine if drug prices rise higher than the inflation rate, creates a monthly insulin cost cap at $35, and eliminates cost-sharing for vaccines covered by Medicare Part D.