If you are interested in enrolling in an MA plan or
switching from your current plan, you should be aware of some important changes that
will take effect in 2023. These changes may affect the availability, affordability,
and quality of MA plans in your area. Here are some of the key updates that you
should know:
- More help with insulin costs. If you have diabetes and
need insulin, you may be able to save money by choosing an MA plan that participates
in the Part D Senior Savings Model. This is a new initiative by the Centers for
Medicare & Medicaid Services (CMS) that aims to lower the out-of-pocket costs of
insulin for MA enrollees. Under this model, participating MA plans will offer a
maximum copay of $35 for a 30-day supply of insulin, regardless of the drug tier or
coverage phase. According to CMS, this could save enrollees an average of $446 per
year on insulin costs [1]. This model will also encourage MA plans to offer more
choices and lower prices for other prescription drugs, such as brand-name and
specialty drugs [2].
- Better access to essential health care services during
emergencies and disasters. If you face an emergency or disaster situation, such as a
hurricane, wildfire, or pandemic, you will have more flexibility and protection when
accessing health care services under your MA plan. CMS has announced that MA plans
will be required to cover medically necessary services at any Medicare-certified
facility during a declared emergency or disaster, regardless of network status or
prior authorization requirements [2]. This means that you will be able to receive
timely and appropriate care without worrying about additional barriers or costs.
This rule will also apply to telehealth services, which have become more widely used
and accepted during the COVID-19 pandemic [3].
- Ability to enroll in any MA plan if you have end-stage
renal disease (ESRD). If you have ESRD, which is a severe kidney condition that
requires dialysis or a transplant, you will have more options when choosing an MA
plan. Previously, ESRD patients were restricted to enrolling in certain types of MA
plans, such as Special Needs Plans (SNPs) or Chronic Condition Special Needs Plans
(C-SNPs). Starting in 2023, ESRD patients will have the same enrollment options as
other Medicare beneficiaries, which may increase their access to more comprehensive
and coordinated care [2]. However, ESRD patients should still compare the costs and
benefits of different MA plans carefully, as some plans may charge higher premiums
or copays for ESRD-related services [4].
These are some of the key updates of MA plans in 2023 that
may benefit you as a current or potential enrollee. For more information on these
and other changes, please refer to the following sources:
[1]
https://www.medicareresources.org/faqs/what-kind-of-medicare-benefit-changes-can-i-expect-this-year/
[2]
https://www.kff.org/medicare/issue-brief/medicare-advantage-2023-spotlight-first-look/
[3]
https://www.cms.gov/newsroom/press-releases/cms-releases-2023-medicare-advantage-and-part-d-advance-notice
[4]
https://www.aarp.org/health/medicare-insurance/info-2023/medicare-changes-in-2023.html
[5]
https://www.medicareadvantage.com/enrollment/medicare-changes-2023
If you are ready to enroll in an MA plan or switch from
your current plan, you can use the Medicare Plan Finder tool at
https://www.medicare.gov/plan-compare/ to compare the plans available in your area.
You can also call 1-800-MEDICARE (1-800-633-4227) or contact your local State Health
Insurance Assistance Program (SHIP) for free personalized counseling and assistance.
