Open Enrollment and 2023’s Medicare Prescription Drug Plans

By: James Flippin · October 24, 2022 · Reading Time: 3 minutes

Quality of Life Issue

Medicare’s open enrollment period is now underway, running from October 15 until December 7. Established in 1965 as part of the Social Security Administration, Medicare provides health insurance for Americans 65 and older. It’s important for beneficiaries to take a close look at their prescription drug plan during this open enrollment period, to make sure they’re utilizing the most cost-effective option.

Prescription drugs are generally delivered via Medicare Part D, and over 75% of beneficiaries have coverage of this type. Because beneficiaries can change their plan during open enrollment, this is a good time to review changes coming for 2023.

What’s Different

The climate, tax, and health care spending bill passed by Congress this past summer caps insulin costs. Part D enrollees will have their cost-sharing capped at $35 per month starting January 1st. On that same track, Part D enrollees will no longer be required to pay any out-of-pocket cost for recommended vaccines.

Some of the changes coming to Part D plans won’t take effect until later this decade. For example, in 2025, beneficiaries’ annual out-of-pocket costs will be capped at $2,000 — currently, no such limit exists. In 2026, Medicare will be permitted to negotiate the price of some drugs.

Pocketbook Planning

It pays to evaluate plans when you can change them, even if you don’t intend to. For instance, plans sometimes change their list of covered drugs year-to-year. Furthermore, although it’s optional to sign up for prescription drug coverage through Medicare, if you don’t sign up at age 65 and choose to later, you will pay penalties in most cases.

Some individuals find they can pay less for prescription drugs by using a discount card, rather than through a Part D plan. Also, keep in mind that your income level is a factor in coverage. People who make over a certain limit face IRMAAs, or income-related monthly adjustment amounts.

Clearly, despite the all-encompassing name that is Medicare, there are numerous things to consider during open enrollment – as there is no “one size fits all” plan.

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