The new year is just around the corner and that’s when new insurance costs take effect. It is Medicare’s custom to announce the next year’s premiums and other costs at different times. For example, the Centers for Medicare and Medicaid Services published 2023 drug plan information in April and the Part B premium in September. So, if you’re planning a budget or want to know how much you’ll pay, here’s a list of the Medicare premiums and other costs for 2023.
Costs that apply to all beneficiaries
No matter the type of Medicare coverage you have, every beneficiary needs to be aware of these costs.
The standard monthly premium for Part B, medical insurance: This will be $164.90. If you’re already receiving Social Security benefits, the premium comes out of your monthly payment. Otherwise, you have been getting invoices.
Income-related Monthly Adjustment Amount (IRMAA): Higher-income beneficiaries pay more for Part B and Part D, prescription drug coverage.
- The 2023 thresholds will be $97,000 for a single filer and a married individual filing separately, and $194,000 for a married individual filing a joint return.
- After crossing the threshold, the monthly amounts for Part B IRMAA (paid in addition to the standard premium) will be $65.90-$395.60.
- The Part D adjustments (paid along with the drug plan premium) will be $12.20-$76.40.
Part D prescription drug coverage: Whether you have a stand-alone Part D plan or a Medicare Advantage plan with drug coverage, these are some costs.
- The base beneficiary premium will be $32.74. No one actually pays this amount; rather it is the basis of the Part D late enrollment penalty and other drug costs.
- The standard deductible will be $505. Plans can charge any amount, up to the set limit.
- Total drug costs of $4,660 will land you in the Coverage Gap (donut hole).
- Cost-sharing in Catastrophic Coverage will be the greater of $4.15 for most generic medications and $10.35 for other drugs or 5%.
Part A, hospital insurance, premium: Most beneficiaries don’t pay a premium for Part A. That’s because they have worked and paid Medicare taxes for 40 quarters (10 years) or have a spouse who has. However, those who haven’t worked enough pay for Part A.
- Individuals who have worked at least 30 quarters will pay a monthly premium of $278.
- Those with less than 30 quarters will pay $506 every month.
Costs for Original Medicare beneficiaries
These costs apply for those who chose the Original path (Part A and Part B) with or without a Medicare supplement plan (Medigap policy).
- Part A will have a $1,600 deductible for inpatient hospitalizations in 2023. This is not an annual deductible; rather it applies to hospital stays in a 60-day benefit period.
- Getting caught in the revolving hospital door could result in additional copayments. If a person is admitted to the hospital repeatedly (without staying out of it for 60 days) copayments come into play: $400 per day for days 61-90 and $800 per day for days 91-150.
Skilled nursing facility (SNF) stay: Part A covers the first 20 days of an SNF stay. In 2023, the beneficiary will pay $200 a day for days 21-100.
Part B deductible: Beneficiaries are responsible for the first $226 of outpatient services next year. Two physician visits or one MRI generally will meet this deductible.
Medicare supplement insurance costs
- The deductible for a high-deductible Plan F and Plan G will be $2,700.
- The out-of-pocket maximum limit for Plan K will be $6,940 and for Plan L, $3,470.
Medicare Advantage costs
These plans establish their costs – premiums, deductible, copayments, and coinsurance. However, Medicare sets some maximums.
- The maximum out-of-pocket limit will be $8,300 for in-network services and $12,450 for in- and out-of-network combined. Plans can set any limit up to that maximum.
- Medical Savings Account (MSA) plans can have a maximum deductible of $15,750.
There you have the nuts and bolts for next year. When it comes to Medicare, we expect costs to rise. Yet it’s surprising that some costs are dropping – the Part B premium and IRMAA. We may not like higher costs, but the reality is they’re basically unavoidable. We have to pay them. Contrary to what some believe, Medicare is not free.