Medicare Costs for 2023: What You Should Know

The Medicare Part B monthly premium decreased for 2023.

The Part B premium for 2023 is $164.90 a month, a 3.1% decrease from 2022.

For Medicare beneficiaries who draw Social Security, the historic rate increase coincides with an increase in their Social Security benefits. The Social Security Administration recently announced a 8.7% Cost-of-Living Adjustment for 2023. The increase means that seniors who are drawing full Social Security benefits and pay their Part B premium through their Social Security checks will actually net more money each month in 2023.

The Centers for Medicare & Medicaid Services (CMS) also announced increases in the Part B deductible and the Part A premium and deductible.

Why is the Part B premium decreasing in 2023?

Medicare Part B, which provides medical insurance for millions of Americans, features a standard monthly premium every year.

In announcing the Part B premium decrease for 2023, CMS shared two reasons for the decreased premium:

• Lower-than-expected spending on Part B items and services.
• Lower-than-expected spending on a new drug, Aduhelm, which was anticipated to increase Medicare spending.
• Both resulted in larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund

CMS noted the same reasons for a decrease in the Part B deductible from $233 in 2022 to $226 in 2023.

How do Part B premiums and deductibles work?

If you are enrolled in Part B of Original Medicare, you are responsible for paying a premium each month that keeps your coverage active.

Your deductible is the amount you pay before your insurance policy will cover its portion of your medical bills. So when you use your Part B coverage by visiting a doctor or purchasing durable medical equipment for example, you typically are responsible for the costs out of pocket until you meet your deductible. After that, you still may be responsible for copays or coinsurance for covered services, but Part B will cover 80% of costs for most services.

Ninety-nine percent of people don’t have to pay a monthly premium for Medicare Part A, commonly referred to as “hospital insurance.” But if you do receive treatment in a hospital or other approved facility, you are responsible for some costs.

• For 2023, the inpatient hospital deductible is $1,600, an increase from $1,556 in 2022. After you pay the benefit period deductible, your Medicare-approved inpatient care for the first 60 days costs you nothing.

• For Days 61-90, you are responsible for $400 of daily coinsurance, up from $389 in 2022.

• For lifetime reserve days (up to 60 days of coverage that you get after Day 90), you pay $800 coinsurance per day used — up from $778 in 2022.

• For approved stays in a skilled nursing facility, Medicare Part A doesn’t require you to pay a deductible or coinsurance for the first 20 days. You pay $200.00 coinsurance for Days 21-100, up from $194.50 in 2022.

Medicare Part A premium for 2023

One percent of Medicare beneficiaries are responsible for the Medicare Part A monthly premium because they (or a qualifying spouse) haven’t paid Medicare employment taxes for 10 or more years (40 or more quarters).

• Individuals who have logged fewer than 30 quarters are responsible for a monthly premium of $506 in 2023, a $7 increase from 2022.
• Individuals who have logged at least 30 quarters but fewer than 40 are responsible for a monthly premium of $278 in 2023, a $4 increase from 2022.

Part B has a standard premium that is set each year, and Part D prescription drug plans have a premium that varies from plan to plan.

But on top of those premiums, higher earners are required to pay higher premiums.

CMS estimates that 7% of Medicare beneficiaries are impacted by the following Income Related Monthly Adjusted Amounts (IRMAA), which are based on your 2021 modified adjusted gross income.

If you were married and lived with your spouse during the tax year but filed a separate return, your Part B IRMAA is as follows.

Annual income up to $97,000

• IRMAA: $0

Annual income from $97,001-$403,000

• IRMAA: $362.60

Annual income greater than $403,000

• IRMAA: $395.60

If you were married and lived with your spouse during the tax year but filed a separate return, your Part D IRMAA is as follows.

Annual income up to $97,000

• IRMAA: $0

Annual income from $97,001-$403,000

• IRMAA: $70.00

Annual income greater than $403,000

• IRMAA: $76.40

You now have a lot of information at your fingertips about 2023 Medicare costs, but what do you do with it? Parts A and B coverage is the cornerstone of Original Medicare. Parts A and B coverage also is at the heart of Medicare Advantage, an alternative to Original Medicare offered by private insurance companies that includes Parts A and B coverage but offers additional benefits and potential savings.

We have and will mention throughout, don’t accept face value. Just because a plan is expensive, doesn’t not make it right for you. Every Medicare plan provides different options for services, including prescription drug prices, provider networks, vision and dental, and more.

Getting coverage that matches your health needs is paramount. Next, you can look at additional coverage and plan flexibility — both vary and come with different costs.

We’ve taken common scenarios for all four parts of Medicare and identified how they compare.

Making an important choice like what health insurance plan to purchase is huge! There are so many details, and there are licensed insurance agents, like GoHealth, that can help you wade through those waters. But if you choose to comparison-shop on your own, consider these four topics over anything else.

Total cost for care

It’s important to think about your total out-of-pocket costs, including deductibles, copayments, coinsurance, maximums, and drug costs, that you’ll pay with a Medicare health or drug plan.

Provider

Some plan types have a network of providers you’ll have to use if you want to pay less. If you have a particular doctor or pharmacy that you prefer to go to, see if that plan has a network.

What benefits do you Need?

Many Medicare Advantage Plans include prescription drug, vision, hearing, and dental coverage.

Overall “Star Rating”

The “Overall Star Rating” gives a rating of the plan’s quality and performance for the types of services each plan offers. A plan can get a rating between 1 and 5 stars.