Leaves are changing, mums are blooming, and pumpkin spice drinks are brewing. For many people this is the signal of Fall, however for us at ET Insurance Inc it is also a signal of open enrollment for Medicare. While the leaves are changing so too are some factors of Medicare 2023. Rising medication cost, with promised solutions, positive changes in deductibles, premiums and anticipated expansion for those with lower incomes are some of the hot topics this season. We will discuss the pumpkin spice drinks later.
Rising costs of medications have been an ongoing issue. With the passing of the Inflation Reduction Act there is hope that more medication expenses will be reduced. For 2023, ten high-cost medications are in price negotiations. However, the negotiated prices are not scheduled to go into effect until 2025-2026. In future years the Inflation Reduction Act proposes that there will be more medication on the list for possible cost reduction.
On a positive note, several of the 2023 prescription drug and Medicare advantage plans are participating in the “insulin savings program”. Most of these plans have copays capped at $35 per month for several insulin brands. This is a huge cost savings for those managing diabetes. Unfortunately, the folks taking name brand blood thinners, inhalers, cancer medications, etc. may still be subject to the higher deductibles and copays. Most will generally lead them to the “donut hole or coverage gap” before year end. Part of the Inflation Reduction Act proposes a $2000 out of pocket cap for Medicare medications. But from what we have heard Medicare is two years away from that projected 2025 start date.
The Center for Medicare Services has made improvements to the cost of getting some vaccines. While flu and covid vaccines have been available at no cost to Medicare beneficiaries, the shingles vaccine will also be added to that list. Starting January 1, 2023 shingles vaccines will also carry a zero copay. Some have wondered why the shingles vaccine has been billed at full price. Previously the shingles vaccine copay was filed through the part D (drug plan). With several of those plans having a large deductible, the payment was full price due to that hurdle. The thought is by offering these vaccines at zero copay it will eliminate any cost barriers that folks may have faced previously.
Except for those receiving Medicaid or extra help from the federal government, Center for Medicare Services has announced that the part B premium will be $164.90, a savings of $5.20 each month. The part B deductible is also going down to $226 for the 2023 calendar year. While that may be somewhat of a surprise, it is a welcomed change after the 2021-2022 premium and deductible increase.
While some things are different, the “get all you deserve ads” and phone center calls are still coming. Medicare has been made aware of fraud and made some changes of their own, some of which affect independent agents. I would like to point out that independent Medicare agents make up less than 1% of all Medicare complaints. However as of October 1, 2022 all calls made, whether independent agents or call centers, regarding Medicare must be recorded and stored for 10 years.
While change is not always welcomed, sometimes it is deemed necessary. I think we would all agree that the leaves and mums are beautiful this season and maybe we should just stop and appreciate them. Pumpkin spice, in my mind, helps with the appreciation of the season. However, I have reached my word count and that is another article altogether. ET Insurance Inc wishes the best for all Medicare beneficiaries that they do “get all they deserve” and feel more confident about the insurance choices they have made for the upcoming year.