How Medicare is Changing in 2023: What Beneficiaries Need to Know

Medicare is the government health insurance program for people over 65, people with certain disabilities, and people with end-stage renal disease. The program has been providing healthcare services for over 50 years, and it has undergone several changes over the years. The year 2023 is no exception, and there are some changes that beneficiaries need to know.

First, the cost of Medicare is increasing in 2023. This is due to several factors, including rising healthcare costs, an aging population, and an increase in chronic diseases. The cost of Medicare Part B, which covers outpatient services like doctor visits and diagnostic tests, is projected to increase by around 6.7%. The cost of Part D, which covers prescription drugs, is expected to rise by about 7.6%. These increases will impact most beneficiaries, but those who earn more than $88,000 per year will see even higher costs due to income-related premiums.

Second, there are some changes to Medicare coverage that will affect beneficiaries. Starting in 2023, Medicare Advantage plans will have the option to offer expanded telehealth services, which can be more convenient for patients who cannot travel to a doctor’s office. Additionally, Medicare will now cover some over-the-counter drugs, including allergy medicine and pain relievers, without a prescription. This change is intended to help beneficiaries save money on healthcare costs.

Third, there are some changes to Medicare enrollment that beneficiaries need to be aware of. The Annual Enrollment Period (AEP) for Medicare Advantage and Medicare Part D plans will now run from October 15th through December 7th each year. This change is intended to give beneficiaries more time to review their coverage options and make changes if necessary. The Initial Enrollment Period (IEP) for Medicare Advantage and Medicare Part D plans will also be changing. Starting in 2023, the IEP will begin three months before a person’s 65th birthday and end three months after their birthday. This change is intended to give people more time to enroll in Medicare.

Finally, there are some changes to Medicare’s quality measurement programs that beneficiaries should be aware of. The Centers for Medicare & Medicaid Services (CMS) has introduced a new Quality Payment Program (QPP) that will affect healthcare providers who participate in Medicare. The QPP will replace the current Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) Incentive Program. The QPP is intended to simplify these programs and improve the quality of care that Medicare beneficiaries receive.

In conclusion, there are several changes to Medicare that beneficiaries need to be aware of in 2023. The cost of Medicare is increasing, and there are some changes to Medicare coverage that will affect beneficiaries. There are also changes to Medicare enrollment and Medicare’s quality measurement programs that beneficiaries should be aware of. It is important for beneficiaries to review their coverage options and make any necessary changes during the Annual Enrollment Period to ensure that they are getting the best possible healthcare at the most affordable cost.