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2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts

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Medicare Part A and Part B premiums, deductibles, and coinsurance amounts, as well as Medicare Part D income-related monthly adjustment amounts, for 2023 were all made public by CMS on September 27, 2022.

Medicare Part B Premium and Deductible

Unlike Medicare Part A, which only covers inpatient hospital stays, Medicare Part B covers outpatient hospital stays, some home health care, durable medical equipment, and other medical and health services.

The Social Security Act is used annually to set the rates for Medicare Part B’s premium, deductible, and coinsurance. In 2023, Medicare Part B enrollees will pay a standard monthly premium of $164.90, down $5.20 from the 2022 rate of $170.10. Medicare Part B recipients will pay a lower annual deductible of $226 in 2023, down from $233 in 2022.

A buffer was built into the 2022 premium to account for any unexpected costs associated with covering Part B expenses for the brand-new drug Aduhelm. Due to lower-than-expected spending on Aduhelm and other Part B items and services, the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund now has significantly larger reserves that can be used to limit future increases in Part B premiums. The reduction in the 2023 Part B premium is in line with the CMS recommendation from a report issued in May 2022 that excess SMI reserves be passed along to people with Medicare Part B coverage.

People who have had a kidney transplant and are beyond the initial 36-month Medicare coverage period may begin in 2023, pay a premium to maintain Part B coverage of immunosuppressive drugs. The cost of immunosuppressant drugs will increase by $97.10 in 2023.

Medicare Open Enrollment and Medicare Savings Programs

The 2023 Medicare Open Enrollment Period (OEP) will run from October 15th, 2022, to December 7th, 2022. Eligible individuals can evaluate the differences between Original Medicare, Medicare Advantage, and Part D prescription drug plans for the calendar year 2023. Fee-for-Service Medicare premiums and cost-sharing information released today will help people with Medicare understand their coverage options for the upcoming year, in addition to the soon-to-be-released premiums and cost-sharing information for 2023 Medicare Advantage and Part D plans. Costs and benefits for Medicare health and drug plans vary from year to year, so beneficiaries should review their coverage options and make a decision that best suits their needs every 12 months.

Low-income seniors and adults with disabilities may be eligible for Medicare Savings Programs financial aid to help with Medicare costs (MSPs). Millions of Americans benefit from the MSPs’ reduced prices and improved quality of care, but only about half of those who are eligible are enrolled. Those who meet the criteria are eligible to have their Medicare premiums paid in full by the MSPs, and they may also have their Medicare deductibles, coinsurance, and copayments covered. People can save money on Medicare expenses by enrolling in an MSP, which they can then put toward more pressing needs such as food, shelter, and transportation. Medicare recipients curious about learning more can go to: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.

Medicare Part B Income-Related Monthly Adjustment Amounts

A beneficiary’s income is used to calculate the monthly Part B premium starting in 2007. Roughly 7 percent of Medicare Part B enrollees have to pay these income-related monthly adjustment amounts. The following table displays the total premiums for high-income beneficiaries with full Part B coverage for the year 2023.

Full Part B Coverage

Beneficiaries who file individual tax returns with modified adjusted gross income:

Beneficiaries who file joint tax returns with modified adjusted gross income:

Income-Related Monthly Adjustment Amount

Total Monthly

 Premium Amount

Less than or equal to $97,000

Less than or equal to $194,000

$0.00

$164.90

Greater than $97,000 and less than or equal to $123,000

Greater than $194,000 and less than or equal to $246,000

$65.90

$230.80

Greater than $123,000 and less than or equal to $153,000

Greater than $246,000 and less than or equal to $306,000

$164.80

$329.70

Greater than $153,000 and less than or equal to $183,000

Greater than $306,000 and less than or equal to $366,000

$263.70

$428.60

Greater than $183,000 and less than $500,000

Greater than $366,000 and less than $750,000

$362.60

$527.50

Greater than or equal to $500,000

Greater than or equal to $750,000

$395.60

$560.50

The following table displays the total Part B premiums for high-income beneficiaries who only require coverage for immunosuppressive drugs in the year 2023.

Part B Immunosuppressive Drug Coverage Only

Beneficiaries who file individual tax returns with modified adjusted gross income:

Beneficiaries who file joint tax returns with modified adjusted gross income:

Income-Related Monthly Adjustment Amount

Total Monthly

 Premium Amount

Less than or equal to $97,000

Less than or equal to $194,000

$0.00

$97.10

Greater than $97,000 and less than or equal to $123,000

Greater than $194,000 and less than or equal to $246,000

$64.70

$161.80

Greater than $123,000 and less than or equal to $153,000

Greater than $246,000 and less than or equal to $306,000

$161.80

$258.90

Greater than $153,000 and less than or equal to $183,000

Greater than $306,000 and less than or equal to $366,000

$258.90

$356.00

Greater than $183,000 and less than $500,000

Greater than $366,000 and less than $750,000

$356.00

$453.10

Greater than or equal to $500,000

Greater than or equal to $750,000

$388.40

$485.50

Full Part B coverage premiums for high-income beneficiaries who are married and who lived with their spouse at any time during the tax year but who file a separate return are as follows:

Full Part B Coverage

Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income:

Income-Related Monthly Adjustment Amount

Total Monthly Premium Amount

Less than or equal to $97,000

$0.00

$164.90

Greater than $97,000 and less than $403,000

$362.60

$527.50

Greater than or equal to $403,000

$395.60

$560.50

Those high-income Medicare recipients who have immunosuppressive drug coverage under Part B and who are married and have filed a separate tax return but have lived with their spouse at any time during the tax year will pay the following premiums:

Part B Immunosuppressive Drug Coverage Only

Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income:

Income-Related Monthly Adjustment Amount

Total Monthly Premium Amount

Less than or equal to $97,000

$0.00

$97.10

Greater than $97,000 and less than $403,000

$356.00

$453.10

Greater than or equal to $403,000

$388.40

$485.50

Medicare Part A Premium and Deductible

Medical care received while an individual is a patient in a hospital, nursing home, hospice, rehabilitation facility, or at home is all covered by Medicare Part A. Because of working for at least 40 quarters in a Medicare-covered job, nearly all Medicare recipients are exempt from paying the Part A premium.

In 2023, the Medicare Part A inpatient hospital deductible that patients must pay if admitted to the hospital will be $1,600, up $44 from the deductible amount of $1,556 in 2022. For the first 60 days of inpatient hospital care in a benefit period, Medicare Part A covers 100% of the costs. Coinsurance amounts for the 61st through 90th day of hospitalization in a benefit period will be $400 per day in 2023 ($389 in 2022) and $800 per day in 2022 ($778 per day) for lifetime reserve days. In 2023, the daily coinsurance for extended care services for beneficiaries residing in a skilled nursing facility will be $200.00 ($194.50 in 2022).

Part A Deductible and Coinsurance Amounts for Calendar Years 2022 and 2023
by Type of Cost Sharing

 

2022

2023

Inpatient hospital deductible

$1,556

$1,600

Daily coinsurance for 61st-90th Day

$389

$400

Daily coinsurance for lifetime reserve days

$778

$800

Skilled Nursing Facility coinsurance

$194.50

$200.00

Medicare Part A requires a monthly premium payment from enrollees age 65 and up with less than 40 quarters of coverage and from certain individuals with disabilities. Premiums for Medicare Part A will increase by $4 per month in 2023 to $278 for those who have 30 or more quarters of coverage or are married to someone who has 30 or more quarters of coverage. The full premium in 2023, an increase of $7 from 2022, will be $506 per month for certain uninsured elderly individuals with less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement.

Medicare Parts A and B premium and deductible Notices (CMS-8080-N, CMS-8081-N, CMS-8082-N) for the year 2023 can be found at:

CMS-8080-N: https://www.federalregister.gov/public-inspection/2022-21180/medicare-program-calendar-year-2023-inpatient-hospital-deductible-and-hospital-and-extended-care

CMS-8081-N:https://www.federalregister.gov/public-inspection/2022-21176/medicare-program-cy-2023-part-a-premiums-for-the-uninsured-aged-and-for-certain-disabled-individuals

CMS-8082-N:https://www.federalregister.gov/public-inspection/2022-21090/medicare-program-medicare-part-b-monthly-actuarial-rates-premium-rates-and-annual-deductible

Medicare Part D Income-Related Monthly Adjustment Amounts

Part D monthly premiums have been income-based for beneficiaries with higher incomes since 2011. Roughly eight percent of Medicare Part D beneficiaries have to pay these income-related adjustment amounts each month. These individuals’ monthly Part D premium payments will also be subject to the income-related adjustment amount. Variable premiums for Medicare Part D are paid either directly to the plan or deducted from the recipient’s Social Security check. Roughly two-thirds of beneficiaries pay premiums directly to the plan. Part D income-related monthly adjustment amounts are deducted from Social Security benefit checks or paid directly to Medicare, regardless of how the beneficiary pays their Part D premium. Monthly amounts for high-income beneficiaries to adjust their Medicare Part D premiums based on their income in 2023 are listed below.

Beneficiaries who file individual tax returns with modified adjusted gross income:

Beneficiaries who file joint tax returns with modified adjusted gross income:

Income-related monthly adjustment amount

Less than or equal to $97,000

Less than or equal to $194,000

$0.00

Greater than $97,000 and less than or equal to $123,000

Greater than $194,000 and less than or equal to $246,000

12.20

Greater than $123,000 and less than or equal to $153,000

Greater than $246,000 and less than or equal to $306,000

31.50

Greater than $153,000 and less than or equal to $183,000

Greater than $306,000 and less than or equal to $366,000

50.70

Greater than $183,000 and less than $500,000

Greater than $366,000 and less than $750,000

70.00

Greater than or equal to $500,000

Greater than or equal to $750,000

76.40

High-income beneficiaries filing separately from their spouse despite having lived together at any time during the tax year will pay the following premiums:

Beneficiaries who are married and lived with their spouses at any time during the year, but file separate tax returns from their spouses, with modified adjusted gross income:

Income-related monthly adjustment amount

Less than or equal to $97,000

$0.00

Greater than $97,000 and less than $403,000

70.00

Greater than or equal to $403,000

76.40

 

 

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2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts

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