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What’s New for Medicare 2023?

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La Rae Mills, LTCP
La Rae Mills, LTCP October 1, 2022

La Rae provides leadership to the Insurance Operations team and oversees the creation and management of processes and compliance for the team. She also leads the Medicare segment of the business. La Rae works closely with carriers and agents to ensure we’re in compliance and working as efficiently as possible.

Disclaimer: Since Medicaid rules and insurance regulations are updated regularly, past blog posts may not present the most accurate or relevant data. Please contact our office for up-to-date information, strategies, and guidance.

There is a lot! So, grab a cup of coffee and a notebook as we take a look at the broad range of changes. This upcoming Medicare season has brought several new regulations and changes. Some of these changes must be implemented immediately, and many are updates you need to know for upcoming enrollments or to share with your clients.

Medicare Updates for 2023

Here’s what you need to know as an advisor this 2023 Medicare season:

  1. Record all Medicare calls. Record all incoming and outgoing calls that pertain to Prescription Drug Plans and Advantage Plans for enrollment within 2023 plans. While you only need to record enrollments that happen over Zoom (or other similar platforms) and by phone, it is highly advised to record all calls until you know the final outcome of the client’s enrollment. You are also required to store these recordings for ten years and provide recordings upon request from carriers or CMS. If you are unsure about how to record and save your recordings, please contact us about our new tool for Medicare advisors or other viable options.
  2. Add the disclaimer. You are required to speak the new disclaimer within the first minute of your enrollment calls. You must also include it in 12-point font on your website, emails, advertisements, texts, and any other means to communicate information about plan details to a consumer. The following is the CMS-required disclaimer: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”
  3. The 2023 Part B deductible premiums have decreased. The annual Part B deductible will be $226, a decrease of $7 from 2022. The new standard monthly Part B premium will be $164.90, a decrease of $5.20 from 2022. To read more about this, click here.
  4. General Enrollment into Original Medicare will have a change in the effective date. In the past, if a person missed their initial enrollment into Medicare and needed to enroll during the General Enrollment Period (GEP), which takes place January-March, their effective date would be July 1. Now, when they enroll during the GEP, their effective date will be the first of the following month.
  5. Initial Enrollment into Original Medicare will no longer have a delay in the beneficiary effective date if enrolled after their birthday month. In the past, if a beneficiary enrolled after their birthday month, the effective date could be delayed anywhere from one to three months after they enroll. These confusing delays are discontinuing starting January 1, 2023, and the effective date for enrollments after a beneficiary’s birthday month will be the first of the following month.
  6. Multiple Prescription Drug changes for 2023. While there will be several changes implemented in 2024 and beyond for out-of-pocket maximums, drug negotiations, and more, in 2023, your clients can get Diabetic insulin when listed on the carrier’s formulary for a maximum of $35 for a one-month supply. Please note that Medicare.gov does not have all this information updated on their plan finder, so contact us if you need assistance with finding and calculating Diabetic insulin for clients. In addition, the expensive Shingles Shot (series of two) will be fully covered in 2023, meaning this will no longer be a financial burden on seniors. Keep in mind that in most cases, the shot must be provided at a preferred pharmacy for a Prescription Drug Plan to cover this particular immunization.
  7. Other minor changes for 2023 include an expansion of Special Enrollment Periods into Original Medicare as well as changes to the Part A deductible, IRMAA amounts, High Deductible Medicare Supplement deductible amounts, and more. If you have any questions on these, please feel free to contact us to discuss them in greater detail.

View all 2023 Medicare changes here.

As you dive into the 2023 Medicare Season, stay calm and breathe easy. While there are many changes this year, we are here to assist you along the way. Please do not hesitate to contact us with any of your Medicare questions and needs.