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The Biggest Medicare Changes for 2023

3 minute read

By Christopher Brown

Key Takeaways

  • Open enrollment begins on October 15, 2022 and closes on December 7, 2022.
  • Insulin copays are capped at $35 a month for all Medicare enrollees with Plan D drug coverage.

The countdown is on. No, we’re not talking about New Year’s.

The end of the summer season is nothing more than a signal designed to warn Medicare eligible Americans of the coming changes to their health plans. Okay, maybe we’re being a little dramatic. But, revisiting your health insurance annually really is important.

There are several important changes coming once again this year. Not only are deductibles, premiums, and coverage options subject to shift beginning in 2023, but the passage of the Inflation Reduction Act in August of 2022 has led to a few changes too.

Today, we’re going to highlight some of the biggest changes coming to Medicare in 2023 with the hope that this discussion inspires you to revisit your health insurance before its too late.

Jerome.Romme/Shutterstock

Capping Insulin Copays

One major change coming to Medicare in 2023 will be music to the ears of the 1.7 million Medicare Part D enrollees that use insulin. Medicare plans for diabetics are about to get much more affordable!

Thanks to the passage of the Inflation Reduction Act, insulin copays will be capped at $35 a month beginning January 1, 2023. That’s a substantial savings when you consider that the average insulin user paid $54 per prescription in 2020.1

COVID-19 Updates

There was a little bit of uncertainty surrounding the COVID-19 pandemic and how Medicare planned to approach it in 2023. All of that uncertainty was squashed with the release of the latest Official Medicare Handbook.

As was the case in 2022, coverage of a wide variety of COVID-19 items and services will continue to be covered, at least until the end of the public health emergency. This continued coverage extends to:

Kidney Transplants and Immunosuppressive Drug Coverage

Another big change that’s coming into effect on January 1, 2023 pertains to immunosuppressive drug coverage for some kidney transplant recipients.

Americans with End Stage Renal Disease (ESRD) would lose their immunosuppressive drug coverage just 36 months after a successful kidney transplant. However, beginning in 2023, Medicare will introduce a new benefit that will provide ESRD sufferers with immunosuppressive drug coverage that extends beyond the 36-month mark.

New Start Dates for Medical Coverage

Big changes are coming for new Medicare enrollees. Americans who are about to turn 65 won’t have to wait as long to begin receiving Medicare benefits.

Starting January 1, 2023, seniors that sign up for Medicare in the month that they turn 65, or during the last three months of the initial enrolment period, or during the general enrolment period will receive coverage beginning the first day of the month following sign up.

New Special Enrollment Period

If you missed Medicare’s Open Enrollment Period, then — for the first time in history — you may be eligible to enroll at a later date.

If you missed the open enrollment period because it slipped your mind, sadly, you’re out of luck. The special enrollment period that takes effect in 2023 is only open to those that miss the open enrolment period as the result of exceptional circumstances.

What qualifies can vary, but generally exceptional circumstances include things like incarceration, losing Medicaid coverage, or a national disaster or emergency. Either way, it’s always advisable to make time to revisit your Medicare coverage during the open enrollment period.

Get Ready for Open Enrollment

As awesome as the new special enrollment period is, you shouldn’t take your chances. Odds are, missing the open enrollment period will mean missing your chance to reevaluate your health insurance needs for another year.

Avoid the headache by marking October 15, 2022 to December 7, 2022 in your calendar. And remember, you won’t be able to alter your Medicare plan before October 15, 2022 or after December 7, 2022. Plus, you can’t expect to see any changes to your plan until January 1, 2023.3

Conclusion

Most of us don’t take the time to review our insurance plans until we’re forced to. Not only does that add a ton of unnecessary stress to an already stressful situation, but failing to re-evaluate your Medicare coverage on an annual basis could end up costing you a lot of money.

You should have received a copy of the Official Medicare Handbook by now. If you haven’t, head on over to medicare.gov, download a copy of the PDF, and review even more changes coming to your coverage in 2023.