- Insulin copays to be capped at $35 in 2023.
- A new special enrolment period gives qualifying enrolees more time to sign up.
If you’re currently enrolled in Medicare or are planning to enroll soon, take heed. Fall is Medicare enrolment season and, as with every year, there are a number of notable changes that could mean big things for you. Predictably, 2023’s Open Enrollment period begins on October 15, 2022 and closes on December 7, 2022. You can’t make any changes to your 2023 Medicare plan before or after that window, so it might be a good idea to write those dates down.
You should always take the time to review your medical situation and explore the annual Medicare changes to ensure that you get the most out of your coverage. Today, we’re going to highlight the five of the most important changes coming to Medicare for 2023.
In 2022, there was some uncertainty surrounding Medicare’s coverage of various COVID-19 preventative services and treatments. As was the case last year, a selection of items and services related to COVID-19 will be covered until at least the end of the public health emergency. Though it is worth mentioning that coverage may change should the COVID-19 public emergency classification be altered before the end of 2023.
The coverage extends to:
- Vaccines: Policyholders pay nothing for any FDA-approved and FDA-authorized vaccines, booster shots, or additional doses.
- Diagnostic Tests: Policyholders pay nothing when ordered by a health care provider to take an FDA-authorized COVID-19 test.
- Antibody Tests: Policyholders pay nothing to take an FDA-authorized antibody test to help see if you’ve developed an immune response and may not be at immediate risk of COVID-19 infection.
- Monoclonal Antibody Treatment: Qualifying policyholders pay nothing for monoclonal antibody treatments to help fight the disease when they get it from a Medicare provider or supplier.
- Over-the-Counter Tests: Policyholders with Part B Medicare coverage pay nothing for up to eight over-the-counter COVID-19 tests at any participating pharmacy or health care provider for each month until the COVID-19 public health emergency ends.
Capping Insulin Copays
2023 is a great year for Medicare Part D enrollees that use insulin. The passing of the Inflation Reduction Act in August of 2022 meant that, in 2023, copays on insulin prescriptions would be capped.
Beginning January 1, 2023, copays for insulin won’t be able to exceed $35 a month for all Part D plans.
Kidney Transplants and Immunosuppressive Drug Coverage
One major change affects those with End Stage Renal Disease (ESRD). In the past, those that only had Medicare because of ESRD would lose their immunosuppressive drug coverage 36-months after a successful kidney transplant. In 2023, Medicare will offer a brand-new benefit that will help policyholders extend aid towards immunosuppressive drugs beyond 36-months.
This new coverage shouldn’t be seen as a substitute for full health coverage as it doesn’t help cover the cost of anything other than the immunosuppressive drugs. Policyholders will be expected to pay a premium for this benefit as well.
New Start Dates for Your Medical Coverage
Great news for anyone turning 65 in 2023. One major update to Medicare means less time waiting for coverage.
As of January 1, 2023, coverage will begin the first day of the month following one’s sign up under certain criteria. It depends if anyone signs up for Medicare during the:
- Month they turn 65;
- Last three months of the initial Enrolment Period, or;
- General Enrolment Period
The Special Enrollment Period
New this year, Medicare has added a special enrollment period that may give you more time to enroll. Starting January 1, 2023, those that miss the enrollment period as a result of exceptional circumstances may be eligible for a special enrollment period.
Exceptional circumstances include:
- A national disaster or emergency, or;
- Losing Medicaid coverage.
If you do have questions regarding your eligibility, it’s best to connect with an official Medicare representative online at Medicare.gov or over the phone at 1-800-MEDICARE.
Medicare enrollees really should take the time to review their coverage at year’s end. It’s hard to keep track of potential changes to your coverage if you don’t sit down and take it all in. If you don’t, you could miss your chance to take advantage of brand-new additions like expanded insulin coverage, COVID-19 treatments, and the adjustment to Medicare’s start date for new enrollees. You should probably make note of the Medicare Open Enrollment opening and closing dates too. Again, those are October 15, 2022 and December 7, 2022.
We may have highlighted some major changes to Medicare coverage taking effect in 2023, but these are far from the only changes. Changes to deductibles, rates, and the state-led Extra Help program may dramatically alter your medical expenses in the coming year.
All the more reason to remain up to date on all things Medicare with professional guidance and thorough research.