Medicare Part B is one of the most essential parts of Medicare because it covers the widest amount of healthcare services. Part B of Medicare stands for your Medicare coverage. Hence, it covers doctor services, outpatient, ambulance, durable medical equipment, preventive care, etc. Part B is different than Part A because it isn’t free. You have to pay for the Part B premium. So, in today’s blog, we will talk about Medicare Part B changes in 2023 which are essential for every Medicare beneficiary.
Upcoming changes for Medicare Part B
The main changes about Part B that are going to happen in 2023 are about Part B premium and Part B enrollment periods, so let’s talk about how these changes may affect Medicare enrollees. As already mentioned, as a Medicare beneficiary, you always have to pay for Part B premium and the cost of it is subject to change each year. For example, this year (2022) Part B premium increased by almost 22$ per month in comparison to the year before.
Part B Premium Decrease
At the end of 2021, Medicare announced the largest percentage price increase for 2022 in the Medicare Part B premium in its history – from 148.10$ to 170.10$ per month. The reason for the increase of almost 15 % is a new Alzheimer’s drug called Aduhelm, a monoclonal antibody treatment that focuses on clearing specific plaque in the brain. This drug is created by Biogen, and they intended on charging 56 000$ for the series of infusions they suggest as a full dosage when a drug is administered as an infusion that is covered under Medicare Part B instead of Part D prescription drug.
So, Medicare decided that a Part B premium increase is needed because of the large cost of the drug. Biogen then decided to reduce the cost from 56 000$ to 28 200$ to help to reduce the burden on Medicare. The reason why Medicare added the cost of this drug to the Part B monthly premium is that they thought that this drug will be highly used but research showed that they aren’t used as expected.
Medicare will announce later this year what the cost of Part B premium will be, but decreasing in its cost is expected.
Part B Enrollment Periods Changes
Currently, Medicare Part B Enrollment Periods have a large number of limitations which means that they may make you wait for a delay in the Part B coverage based on when you have enrolled. On the other hand, the new rule that is proposed for 2023, will change the effective dates of Medicare beneficiary coverage for traditional Medicate based on when the beneficiary will enroll.
Also, they will authorize Special Enrollment Periods for some Medicare beneficiaries and also extend Part B coverage for specific medications for kidney transplantation recipients. Now, let’s break down enrollment period changes to make them more clear.
Part B Initial Enrollment Period
Also known as AEP (Annual Enrollment Period), it is a 7-month open window period that starts 3 months before your 65th birthday and ends 3 months after your 65th birthday. In 2022 if you enroll three months later you turn 65 your Part B effective date can be delayed.
The good news is, that this new proposed rule, would make your Part B effective date be the first day of the following month if you enroll in the later part of your Initial Enrollment Period. This means that there will be no delays in your coverage because Part B will be effective the first month you apply.
This is a huge difference, because in 2022 if you miss your Initial Enrollment Period and do not have other creditable employer-based health coverage then you will have to wait until the Medicare Part B General Enrollment Period to apply for Medicare, and that’s from January 1st to 31st of March every calendar year. Right now, if you are a Medicare beneficiary and apply during the General Enrollment Period then your Part B coverage doesn’t start until July 1st of that year. This means that you will face the late enrollment period penalty which you’ll be obligated to pay for each month you should have had Medicare Part B, but you missed the Initial Enrollment Period.
Part B Special Enrollment Period
Part B Special Enrollment Period will be valuable for each Medicare enrollee which had missed the Initial Enrollment Period, for example, because their current employer mislead the information at the time of enrollment or they missed letting beneficiaries know that their coverage wasn’t creditable. In this case, beneficiaries can apply for Medicare Part B at any point during the year without paying a penalty as long as they can prove those circumstances and will not have to wait for their coverage to begin.
But, even if you don’t qualify for the Special Enrollment Period, and you have to wait for General Enrollment Period to begin, you will no longer have to wait for July 1st for your Part B coverage to begin. Instead of that, your coverage will now start on the first day of the next month based on when you applied for Part B coverage.
Conclusion
Proposed rules for Medicare Part B changes in the upcoming year are definitely good news for each Medicare beneficiary. Even though we don’t yet know how much will part B premium cost next year, it will definitely increase which is a huge change because of the increasing largest increase in monthly premium in the current year. Also, the new rules of Enrollment Periods for Medicare Part B in 2023 will give Medicare beneficiaries more flexibility and help them avoid paying late enrollment fees.
If you have any questions about Medicare, and how it works, licensed Medicare brokers in Jersey Insurance Solutions are here to answer all your questions. We will guide you through the world of Medicare so turning 65 shouldn’t be scary!
Call us or text us today, and let’s begin our Medicare journey together! For more informations about your Medicare coverage in Jefferson area, you can check out our blog here.
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
