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Your Guide to Medicare Open Enrollment 2023

Posted: October 20, 2022
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Medicare Open Enrollment is happening NOW

During this time, you can make changes to your prescription drug plan, enroll in a prescription drug plan, change your Medicare Advantage Plan, or enroll in a Medicare Advantage Plan.

What is New for 2023

*Part B premium will be reduced from $170.10 to $164.90.

*Part B deductible will be reduced from $233 to $226.

*There is now a Plan G Plus plan which includes dental and vision benefits along with your medical benefits.

*Many carriers offering Medicare Advantage plans have decreased the maximum out of pocket.

*Many carriers offering Medicare Advantage plans have increased dental benefits.

*There is now a Medicare Advantage plan being offered for $187 per month with $0 out of pocket expenses.

*Part D deductible will increase from $485 to $505.

*The initial figure needed to enter the donut hole has increased from $4,430 to $4,600.  As a reminder, Medicare is keeping a running total of the full cost of your drugs.  When you reach this figure, your coverage level (i.e. co-pays) change.

*Part D TROOP will increase from $7,050 to $7,400. This is the amount you are responsible for before exiting the donut hole and entering catastrophic coverage.

Reminders

Medicare Supplemental plan premiums increase each year as you age.

You can change your Medicare Supplemental plan at ANY time; however many carriers will medically underwrite before accepting a new policy.  This means the policy can be denied or you can be charged a higher rate due to your medical history.

What you need to know about the Basics of MEDICARE

Part A is provided by Social Security and covers HOSPITALIZATION.  The deductible is $1,600 and most people do not pay a monthly premium.

Part B is also provided by Social Security and covers DOCTOR VISITS at 80%.  In 2023 the Part B premium will be $164.90/month.  Most people have the premium deducted from their Social Security.  The deductible for Part B is $226.  As a side note, Part B premium is based on income.  If your income is greater than $85,000 for an individual or $170,000 for those that file a joint return, you will pay a higher premium. 

WHAT DOES THIS MEAN???  If you only have original Medicare, you will pay 100% of your doctor visits and hospital visits until you reach your deductible.  Once you meet the deductible (i.e. $226 per year for doctor visits and $1,600 for each hospitalization outside of 60 days). Medicare will start paying 80% of the bill for doctors’ visits and 100% of the hospitalization for the first 60 days. 

It is important to note that not all doctors accept Medicare.  You will need to confirm with your doctor that they accept Medicare before making your appointment.

WHAT ABOUT PRESCRIPTION DRUGS???  For those that are Medicare eligible, you are REQUIRED to purchase a prescription drug plan if you do not have credible coverage.  Prescription drug plans are provided by private insurers (i.e. BCBS, Humana, United Healthcare/AARP, etc.), NOT Social Security. 

Many people think prescription drugs are included in Part A and Part B…they are NOT.  If you choose not to purchase a plan, you will be penalized 1% of the average premium for each month that you do not have coverage.  Although this figure sounds low, it does add up over time.  The penalty is NEVER removed.  Once you are assessed a penalty it will be added to your monthly premium (i.e. $30/month premium + $20 penalty = $50 monthly premium). 

Prescription Drug plans are subject to an enrollment period.  The enrollment period is NOW.  If you qualify for a special election period (i.e. aging in to Medicare or losing credible coverage) you will be eligible for enrollment based on the date of your eligibility.

Prescription Drug plans have a monthly premium, co-pays are charged based on which Tier your drug falls in to, and some plans charge a deductible.  It is important to review your drug list before switching carriers.