It’s a safe bet that you’ve never seen the words “news” and “Medicare” used in the same sentence. However, if you are a Medicare beneficiary, or soon will be, the 2023 prices for various Medicare items are worth knowing. Here are seven of them:
- Most Medicare beneficiaries pay a monthly Part B premium. In 2023 that premium will be $164.90, down from this year’s $170.10. This is the first decrease since 2012, according to the Kaiser Family Foundation, although the Part B premium increased in neither 2014 nor 2015.
- The Part B deductible will be $226 in 2023, down $7 from this year’s $233.
- Medicare beneficiaries in Marion and Polk counties have access to 25 Medicare Advantage insurance plans in 2023 that offer both health and drug coverage. These plans are offered by eight insurers.
- Of those 25 plans, nine have no monthly premium. Companies can offer zero-premium insurance because Medicare subsidizes the premium by more than $800 a month for all beneficiaries, regardless of income.
- One advantage of replacing Original Medicare (that is, Medicare only) with Medicare Advantage insurance is that the insured’s out-of-pocket cost for medical services is capped. Among plans available here the annual out-of-pocket medical cost is capped from $3,000 to $7,550, depending on the plan. Among the nine zero-premium plans, the out-of-pocket ceiling for medical costs ranges from $4,500 to $7,550.
- Missing in 2023 will be five-star Medicare Advantage plans. These are plans in which someone who missed enrolling, or who wants to leave a plan, may enroll at any time. Medicare beneficiaries in Marion and Polk counties had access to two insurance companies offering five-star plans this year.
- Medicare beneficiaries will have access to 24 prescription drug plans offered by nine companies in 2023. The least expensive plan will cost $11.10 a month; more than half of the plans have premiums of less than $50.
Numbers not yet available are those showing income eligibility for Medicare benefits such as reduced pharmacy costs, having the Medicare Part B premium paid or having all medical costs paid. These numbers, which apply to Medicare beneficiaries with modest incomes, should be available in February.
A Senior Health Insurance Benefits Assistance (SHIBA) volunteer counselor could help you with insurance or other Medicare subjects. If you would like to make a SHIBA appointment, or to ask a question to be answered in this space, please see the end of this column.
I’m turning 65 at year’s end and retiring from my public job. I’m trying to decide between PERS insurance and Medicare insurance outside of PERS. What do you think?
It’s definitely your personal decision, although a SHIBA counselor could point you toward questions you might ask. Also, the Public Employees Retirement System (PERS) prefers to talk about its insurance plans, so if you’re considering its insurance be sure to call (800-768-7377) to ask your questions.
Let’s say you’re looking at two specific 2023 Medicare Advantage insurance plans offered by the same company, one through PERS and the other the company’s most expensive plan on the Medicare open market.
In this comparison the PERS insurance is significantly more expensive, $267.60 a month versus $173. Most (not all) benefits are also better with the PERS insurance. For example, your maximum out-of-pocket medical costs during the year would be capped at $1,500 compared with $3,400 with the non-PERS plan that you could compare on Medicare.gov. Besides that, for example, your cost for inpatient hospitalization, for hospital emergency care or for urgent care would be less with the PERS insurance. PERS has a more generous benefit for temporary skilled nursing care. Cost for ambulance service could be the same, although PERS says its plan includes air ambulance while the other plan is for ground ambulance only.
Very important, compare the cost of your prescription drugs with both plans. Also be sure your doctor(s) will accept the plan you decide you like.
Granted, this doesn’t answer your question. If you don’t already have it, obtain the 2023 PERS booklet that spells out costs and benefits of its Medicare insurance. Also find a plan you like on the Medicare.gov website. Make a grid, and compare costs and benefits of the two plans, paying special attention to what matters most to you.
Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone appointment with a volunteer Medicare counselor, call 800-722-4134.
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