CMS announces lower premiums for Medicare Advantage plans in 2023
Cost-sharing limit for insulin is $35 a month and recommended adult vaccines will be at no additional cost.
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People with Medicare will see lower premiums for Medicare Advantage and Medicare Part D prescription drug plans in 2023.
The projected average premium for 2023 Medicare Advantage plans is $18 per month, a decline of nearly 8% from the 2022 average premium of $19.52.
As previously announced, the average basic monthly premium for standard Part D drug coverage is projected to be $31.50, compared to $32.08 in 2022.
Additionally, due to the Inflation Reduction Act, Medicare prescription drug coverage will include a $35 cost-sharing limit on a month's supply of covered insulin, as well as adult vaccines that are recommended by the Advisory Committee on Immunization Practices, at no additional cost.
WHY THIS MATTERS
The Centers for Medicare and Medicaid Services has released information on lower premiums in Medicare Advantage plans, and lower premiums and deductibles for beneficiaries who have regular Medicare coverage, ahead of the upcoming Medicare Open Enrollment beginning October 15.
Enrollment in Medicare Advantage continues to increase, CMS said. Projections indicate enrollment in private health insurance will reach 31.8 million people in 2023.
Medicare Advantage health plans cover all Medicare Parts A and B benefits and often provide additional benefits such as eyewear, hearing aids, preventive and comprehensive dental benefits, access to meals (for a limited duration), over-the-counter items and fitness benefits.
In addition, more than 1,200 Medicare Advantage plans will participate in the CMS Innovation Center's Medicare Advantage Value-Based Insurance Design (VBID) Model in 2023, which tests the effect of customized benefits that are designed to better manage diseases and meet a wide range of health-related social needs, from food insecurity to social isolation. The benefits under this model are projected to be offered to 6 million people.
The VBID Model's Hospice Benefit Component, now in its third year, will also be offered by 119 Medicare Advantage plans in portions of 24 states and U.S. territories, providing enrollees increased access to palliative and integrated hospice care.
New policies related to cost sharing are estimated to increase payment from MA plans to providers serving dually eligible Medicare and Medicaid individuals who incur high costs. In 2023, CMS will begin to require all Medicare Advantage dual eligible special needs plans (D-SNPs) to establish enrollee advisory committees and consult with those committees on various issues, including improving health equity for underserved populations.
THE LARGER TREND
Earlier this week, CMS released the 2023 premiums, deductibles and coinsurance amounts for fee-for-service Medicare Part A and Part B, and the 2023 Medicare Part D income-related monthly adjustment amounts.
Medicare Open Enrollment runs from October 15 to December 7. During this time, people eligible for Medicare can compare 2023 coverage options on Medicare.gov.
The Medicare Plan Finder will be updated with the 2023 Medicare health and prescription drug plan information on October 1. The number 1-800-MEDICARE is also available 24 hours a day, seven days a week to provide help in English and Spanish as well as language support in over 200 languages.
People who want to keep their current Medicare coverage do not need to re-enroll.
During Open Enrollment, people with Medicare who take insulin are encouraged to call 1-800-MEDICARE or contact their State Health Insurance Assistance Programs for help comparing plans and costs.
To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs.
ON THE RECORD
"The Inflation Reduction Act will provide much needed financial relief and increase access to affordable drugs," said CMS Administrator Chiquita Brooks-LaSure. "It is more important than ever for people to review their healthcare coverage and explore their Medicare options during Open Enrollment this year."
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
