Lower Medicare premiums, more cost savings ahead for Florida seniors [South Florida Sun-Sentinel]

Open enrollment for Florida’s Medicare beneficiaries comes with some positive news: Most seniors will see cost savings in 2023.

For the first time in more than a decade, Floridians will see a reduction in their premiums in 2023 for Medicare Part B and Medicare Advantage plans.

The much-celebrated decrease will save Floridians about $5.20 a month on their premiums for the part of Medicare that covers doctor’s services, outpatient hospital services and certain home health services. Seniors pay the premiums whether they are on original Medicare or Medicare Advantage plans, and typically the charge is deducted from Social Security payments.

The standard monthly premium for Medicare Part B will drop to $164.90 for 2023, from $170.10 in 2022. Beneficiaries with higher incomes pay more than the average through what is known as income-related adjustment amounts.

“Lower Medicare premiums are great news for millions of seniors and people with disabilities,” said U.S. Rep. Lois Frankel, after advocating in Congress for improvements to Medicare.

Along with a reduction in the Medicare Part B premiums, beneficiaries will see a decrease in their annual deductible, which is the amount someone pays for healthcare services before the government insurance kicks in. The deductible is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022.

“For Florida’s seniors, any little bit of cost savings helps,” said Evan Tunis with Florida Healthcare Insurance in Coral Springs.

Fall enrollment underway

The annual election period for Medicare runs from Oct. 15 to Dec. 7 and is the time when you can switch from one Medicare Advantage plan to another, or from one prescription drug plan to another. With Medicare, one option is choosing Original Medicare to pay for doctors and adding a drug plan to pay for prescription medications. A second option is choosing a Medicare Advantage Plan, which has more restrictions on doctors and services but is an all-in-one that includes drug coverage and often extra benefits.

During open enrollment, you can switch between those two options.

Anyone already in a Medicare plan will get information this month on changes to coverage for 2023. The changes could be adjustments to your monthly premium, co-pays, deductible, coinsurance or maximum out-of-pocket limit, or changes to drug coverage.

You are not required to do anything during open enrollment if you want your 2022 coverage to continue into 2023. However, experts say with annual changes to plans, you should always check for your best option.

More Medicare Advantage plans in Florida

Florida has 4.86 million people enrolled in Medicare, making it the state with the second-highest number of enrollees after California. Because of that, Florida attracts Medicare Advantage plans, and in 2023 there will be 44 more plans available in the state than last year.

“This year there are more carriers with more options,” Tunis said. “Lots of plans look similar, so any plan you are considering, you need to do an evaluation of whether your doctors and hospitals are on it, and whether your medications are covered.”

Ari Parker, co-founder and lead Medicare adviser at Chapter, a Medicare advisory company, said doctors and other healthcare providers come off and on health plans from year to year, making an annual review particularly important.

“You should review how your plan worked for you in 2022 and make sure if you liked it, it will work similarly in 2023,” Parker said. “Confirm if your doctors are covered in network, if your prescriptions will be covered, and that it still offers the additional benefits you want such as dental and vision.”

If you shop for Medicare Advantage plans in Florida, you will find they generally are offering more in the way of extra benefits in 2023. Some of those benefits include eyewear, hearing aids, preventive and comprehensive dental benefits, access to meals, over-the-counter items, and fitness benefits.

Medicare Advantage plans typically have an additional premium — and this year it should be slightly lower. The projected average premium for 2023 Medicare Advantage plans is $18 per month, a decline of nearly 8% from the 2022 average premium of $19.52.

Tunis notes that Florida’s snowbirds or people who travel will want to be cautious when choosing a Medicare Advantage plan that limits them to certain doctors. “You need a good PPO (Preferred Provider Organization) plan so if you travel your healthcare costs will be covered.”

Kate Ashford, a Medicare specialist for NerdWallet, recommends looking at the big picture when choosing a Medicare Advantage plan. “So many plans advertise zero-dollar premiums,” she said. “It’s free only if you never see a doctor. You still have deductibles, and co-pays and co-insurance and a maximum out-of-pocket. So even if a plan has a zero-dollar premium, you need to look at how much overall you could spend.”

Changes in drug costs

If you don’t have an Advantage Plan and choose Original Medicare Part B with a supplemental drug plan, your premiums on those drug plans will be lower in 2023.

The Centers for Medicare & Medicaid Services (CMS), which reviews the drug policies, said in 2023, the average premium would be about 1.8% lower than in 2022, falling to $31.50 from $32.08 in 2022. However, that’s an average and some plans will see increases.

The drug policies are sold by private insurers, who set the terms and premiums annually. In Florida, 23 stand-alone Medicare prescription drug plans are available in 2023.

As you consider your 2023 coverage, be aware that some Medicare-related provisions of the recently passed Inflation Reduction Act target drug costs and take effect in 2023.

For example, Medicare prescription drug coverage will include a $35 cost-sharing limit on a month’s supply of covered insulin, significant savings for seniors with diabetes. Also, there will be no cost for all adult vaccines recommended by the Advisory Committee on Immunization Practices, such as shingles.

Many Florida seniors look forward to seeing a $2,000 annual cap on medication costs as part of their drug plans, but that provision of the Inflation Reduction Act won’t go into effect until 2025.

This year, seniors may find their medications fall into different tiers of coverage within plans than in 2022— some costs will go up and some will go down, notes Edith Thompson, who oversees Medicare counseling for the SHINE program offered by the Area Agency on Aging Broward, said in 2023,

“You will need to look carefully at the drugs you take and how they are covered in different plans,” Thompson said. “Sometimes you can save a lot of money by making a move.”

Sun Sentinel health reporter Cindy Goodman can be reached at [email protected].

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