If you’re 65 or older, Medicare is there to help you get the health care coverage you need. For hospital and inpatient care, Medicare Part A is the option used by tens of millions of people. But to cover routine doctor visits and other outpatient care, Medicare Part B is the traditional choice for many program participants.
Medicare participants can expect many different changes to the program in 2023. Here are the ones that will affect Part B the most, with a brief overview to introduce you to the program first.
What Medicare Part B gives you
For the most part, if you need medical treatment that doesn’t require a stay in a hospital or other treatment facility, Part B is what covers you. Anything from a regular medical checkup to outpatient surgical procedures can qualify for Part B coverage. Plus, if you need medical equipment, ambulance transportation, diagnostic tests, or treatment for mental health problems, Part B provides coverage. there, as well as for a wide range of other health care problems.
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Medically necessary conditions are generally covered under Medicare Part B, with the goal of providing the resources necessary to detect, diagnose, and treat an illness, injury, or other medical condition. You can also get some preventive care services under Part B, like an initial wellness intake appointment when you turn 65, as well as checkups every year thereafter to ensure your continued health.
However, Medicare Part B does not cover everything. If you need dental care, eye exams for glasses or contacts, or hearing aids, you usually can’t count on Part B to cover it. Some more experimental or less medically accepted treatment options also do not qualify under Medicare Part B.
Why Medicare Part B costs are falling in 2023
Part B requires monthly premium payments. Most people will pay $164.90 per month for full Part B coverage, which is down from $170.10 per month in 2022.
The decline comes from the partial reversal of a large increase last year. That came as Medicare initially expected the new Aduhelm treatment for Alzheimer’s disease to be extremely expensive but also qualify for blanket coverage under the program. In the end, Medicare opted to offer more limited coverage, and that caused premiums to drop for 2023.
New coverage under Medicare Part B is available this year for those who are 36 months or older after receiving a kidney transplant. These patients do not qualify for full Part B coverage, but may elect to get partial coverage for immunosuppressive drugs for less than $97.10 per month.
However, some people with higher incomes pay extra amounts for their Medicare Part B coverage. As you can see below, those at certain income levels have to pay up to $560.50 per month in premiums. Keep in mind that income levels go back two years, so it’s your 2021 modified adjusted gross income that determines what you pay in 2023.
|
For individuals with these incomes in 2021: |
OR joint filers with this income in 2021: |
The total monthly premium in 2023 for full Part B will be: |
The total monthly premium in 2023 for partial Part B will be: |
|---|---|---|---|
|
$97,000 to $123,000 |
$194,000 to $246,000 |
$230.80 (down $7.30) |
$161.80 |
|
$123,000 to $153,000 |
$246,000 to $306,000 |
$329.70 (down $10.50) |
$258.90 |
|
$153,000 to $183,000 |
$306,000 to $366,000 |
$428.60 (down $13.70) |
$356 |
|
$183,000 to $500,000 |
$366,000 to $750,000 |
$527.50 (down $16.80) |
$453.10 |
|
More than $500,000 |
More than $750,000 |
$560.50 (down $17.80) |
$485.50 |
Data source: Centers for Medicare & Medicaid Services. Note: Married individuals filing separately who lived together at any time during the year pay $527.50 for full coverage or $453.10 for partial coverage if their income is $97,000 to $403,000, or $560.50 for full coverage or $485.50 for partial coverage if your income is more than $403,000.
In addition, Medicare Part B participants have to pay two other costs. They must pay a $226 deductible in 2023 before coverage kicks in, which is $7 less than in 2022. More importantly, Medicare typically covers only 80% of costs for most items, leaving you to pay 20 % remaining.
Stay healthy with Medicare Part B
Planning for retirement requires being smart about your health care coverage. Using Medicare Part B to its fullest will play a vital role in ensuring that you can stay healthy without breaking the bank.
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