Thanks to the Inflation Reduction Act, enrollees will have lower costs for insulin and free ACIP-recommended vaccines starting in 2023. People with Medicare should review their coverage and drug and health plan options through December 7, 2022 on Medicare.gov
Medicare Open Enrollment begins tomorrow — Saturday, October 15 — and will remain open through December 7, 2022. Medicare’s Open Enrollment period gives people with Medicare the opportunity to make changes to their health plan or prescription drug plan, pick a Medicare Advantage plan, or return to Original Medicare (also referred to as Medicare Part A and Part B). Medicare plans can change their offerings and costs every year, and individuals’ health needs can change from year-to-year, too. Now is the time for people with Medicare to review their coverage options and make a choice that best meets their health care needs.
The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority. Just last month the Biden-Harris Administration announced that people with Medicare will see lower average premiums for Medicare Part B, Medicare Advantage, and Medicare Part D prescription drug plans in 2023.
This year, thanks to the Inflation Reduction Act that President Biden signed into law in August, Medicare enrollees will also see lower costs for insulin and vaccines beginning in 2023. Starting in 2023, all people with Medicare who take insulin covered by their prescription drug plan or through a traditional pump covered under Original Medicare will pay no more than $35 in cost-sharing for a month’s supply of each covered insulin product. People with Medicare also will not pay a deductible with respect to each covered insulin product. Additionally, people with Medicare drug coverage will pay nothing out-of-pocket for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) — including the shingles vaccine and Tetanus-Diphtheria-Whooping Cough vaccine. More information on the Inflation Reduction Act and these changes is available at https://www.cms.gov/newsroom/fact-sheets/inflation-reduction-act-lowers-health-care-costs-millions-americans.
“This year, more than ever, it is vital that people with Medicare review and compare their options to find the coverage that best meets their needs,” said HHS Secretary Xavier Becerra. “Thanks to the Inflation Reduction Act, we are lowering the cost of insulin and vaccines for the more than 64 million people with Medicare. The Biden-Harris Administration is unwavering in our commitment to strengthening Medicare, and we will keep doing all we can to lower costs and improve benefits.”
“We are committed to providing comprehensive and easily accessible information to support people with Medicare in their decision making,” said CMS Administrator Chiquita Brooks-LaSure. “Medicare.gov makes it easier than ever to compare coverage options and shop for plans. People can do a side-by-side comparison of plan coverage, costs, and quality ratings to help them more easily see the differences between plans.”
Since 2021, CMS has introduced a number of enhancements to Medicare.gov to optimize customer experience and create a more welcoming and user-friendly experience. Improvements include a redesigned Medicare.gov home page, the addition of pricing details to the Medigap policy comparison, streamlined landing and summary on the Medicare Plan Finder, and a redesigned “Talk to Someone” section to find additional help and contacts. All of these enhancements improve the overall experience, making it easier to navigate and access information to compare and select health and drug coverage and find providers.
The Medicare Open Enrollment period occurs every year from October 15 through December 7, with coverage changes taking effect January 1.
Things to Consider When Shopping for Medicare Coverage
- There are two main ways to get your Medicare coverage — Original Medicare and Medicare Advantage (Medicare-approved plans from private companies). There are differences between the two that are important to understand when choosing your coverage.
- If you are selecting a Medicare Advantage plan, check with your health care providers to confirm they are in a plan’s network.
- If you are selecting a Medicare prescription drug plan, check if your prescriptions are included on a plan’s formulary.
- Remember that a low monthly premium may not always be the best overall value to meet your specific needs.
- Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs.
- If you take insulin, there is a new out-of-pocket cap on a month’s supply of each insulin product when covered by a prescription drug plan or under Original Medicare. Talk to someone for help comparing plans by calling 1-800-MEDICARE
Medicare is Here to Help
Here are four ways you can compare plans and look at savings options:
- Go to Medicare.gov to learn the difference between Original Medicare and Medicare Advantage, and do side-by-side comparisons of costs and coverage for Medicare Advantage and prescription drug plans.
- Call 1-800-MEDICARE. Help is available 24 hours a day, including weekends.
- Access personalized health insurance counseling at no cost, available from State Health Insurance Assistance Program (SHIP). Visit shiphelp.org or call 1-800-MEDICARE for each SHIP’s phone number. Many SHIPs also offer virtual counseling.
- Check eligibility for Medicare Savings Programs. If you have limited income and resources, you could qualify for Medicare Saving Programs run by your state Medicaid program. These programs could help save you money on health and prescription drug costs and/or could reduce your Part B premium from $165 to $0. For more information, contact your state Medicaid program or call 1-800-MEDICARE and ask about Medicare Savings Programs.
For more information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Help is available 24 hours a day, including weekends.