NEWS

5 Changes to Expect During 2023 Medicare Open Enrollment

two older adults looking at drug label info

Verywell / andreswd / Getty Images

Key Takeaways

  • Medicare open enrollment begins on October 15 and ends on December 7.
  • You can expect several changes to Medicare next year, including lower costs related to Medicare Part B and Part D premiums.
  • Older adults enrolled in a Medicare Advantage plan or Medicare Part D, specifically, should check their plans to be aware of any change for 2023, and compare potential new plans.

October 15 is the start of the 2023 Medicare Open Enrollment period for the 60-plus million Americans who are beneficiaries. Enrollment ends December 7, and any changes you make go into effect on January 1, 2023. 

The enrollment period is the time of year when people with Medicare can make unrestricted changes to their coverage options.

Will You Be New to Medicare in 2023?

There are new start dates for new Medicare enrollees beginning January 1, 2023. Your initial enrollment period can happen in the three months ahead of turning 65, the month you turn 65, or the three months afterwards. If you sign up during the month you turn 65 or in the following three months, your coverage starts the first day of the month after you sign up. That is sooner than coverage in previous years.

If you’re already enrolled, it’s still worth reviewing your options for 2023, especially in light of several changes to the program.

"During the enrollment period, Medicare beneficiaries can review how they receive their Medicare coverage for 2023," Judith Stein, JD, the executive director of the Center for Medicare Advocacy, told Verywell.

Stein said that whether people have traditional Medicare with a Part D prescription drug plan or are enrolled in a private Medicare Advantage plan, "all beneficiaries should make sure that the options available to them will meet their needs in the coming year."

Key Changes for 2023

While you may have heard that Congress recently passed a law allowing Medicare to negotiate some drug prices, that doesn’t begin until 2026. However, there are some key changes for 2023. 

Lower Costs for Part B: Many people will see small decreases in their Part B premium and deductible. The standard monthly Part B premium in 2023 will be $164.90, down from $170.10 in 2022. The annual Part B deductible decreases to $226, down from $233 in 2022.

What Is Medicare Part B?

Medicare Part B helps pay for medically necessary outpatient and physician services or drugs, like chemotherapy.

Lower Premiums for Part D: The base premium for a Medicare Part D prescription drug plan will be $32.74 per month, down from $33.37 in 2022. However, premiums for specific plans and regions vary from year to year and may be higher or lower, according to the Medicare Rights Center. That means it’s important for people to carefully examine their Annual Notice of Change (ANOC) to determine if and how their plan’s costs or benefits are changing and if it makes sense to explore other options.

You should have received the ANOC by September 30 via email or regular mail. Didn’t get it? Call your plan. 

What Is Medicare Part D?

Medicare Part D is a supplement to Medicare that covers prescription drugs that older adults take at home. In addition to their monthly premiums, those enrolled in Medicare Part D pay a portion of the cost of most prescription drugs they need.

Copay Limits for Insulin: Copays for insulin for all beneficiaries will be limited to $35 per month. This applies to all insulin covered by a beneficiary’s Part D plan or under Medicare Part B.

Coverage for Vaccines: People with Medicare will pay no copays or deductibles for some vaccines covered by their Part D plan, including the shingles vaccine and flu shot. For now, COVID-19 vaccines and boosters remain free with no copay for all Americans.

Higher Barriers to the Coverage Gap and Catastrophic Coverage: Not all Medicare numbers are going down. Medicare beneficiaries will enter the coverage gap—where they pay out of pocket for medications—after their total drug costs reach $4,660 (up from $4,430 in 2022). Once in the coverage gap, beneficiaries have a 75% discount on the cost of brand name and generic drugs.

If Medicare beneficiaries have spent enough money out of pocket while in the coverage gap, they may qualify for something called "catastrophic coverage." During this period, people pay significantly lower copayments or coinsurance for covered drugs. In 2023, beneficiaries will reach catastrophic coverage after paying $7,400 out of pocket on drugs (up from $7,050 in 2022).

What If I Have a Medicare Advantage Plan?

Medicare Advantage plans are private plans you can enroll in instead of original Medicare. They are often area-specific.

Medicare Advantage plans limit your choice of physicians to those who participate in your plan, but may also add some benefits, such as vision care and coverage of rides to the doctor.

"You can reevaluate your choice every year and make sure you’re enrolled in the coverage that's best for you," Jane Sung, JD, a senior strategic policy advisor for AARP told Verywell, explaining new plans may become available in your area in 2023.

Use Medicare’s Plan Finder tool to compare Medicare Part D or Medicare Advantage plans. The plan finder compares covered health care services, providers, medications, pharmacies, and drug costs.

According to Stein, Medicare Advantage plans should consider the following questions during the enrollment period:

  • Will my doctors, health care providers, hospitals, and healthcare institutions be in my plan next year?
  • Will my medications be included in a drug plan, within Medicare Advantage, or in Part D?

"Most people don't take advantage of open enrollment opportunities as much as perhaps they should,” Sung said. "Now is a good time to look at your own coverage priorities and to be aware that there are a lot of different choices out there. Enrollment is a process that can take some time to get through."

What This Means For You

Medicare open enrollment starts Saturday, October 15. If you have Original Medicare and a supplemental plan and are happy with your coverage, you do not need to make a change.

If you have a Medicare Advantage or Part D plan, you should review all your coverage options, even if you are happy with your current coverage, because plans change each year.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Medicare.gov. What does Medicare cost?

  2. Medicare.gov. Part D late enrollment penalty.

  3. Medicare.gov. Costs in the coverage gap.

  4. Medicare.gov. Catastrophic coverage.

By Fran Kritz
Fran Kritz is a freelance healthcare reporter with a focus on consumer health and health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.