For 2023, the standard beneficiary has a selection of 43 Medicare Benefit plans as an alternative choice to conventional Medicare, a brand new KFF evaluation finds. That’s a rise of 5 plans on common from 2022, including much more decisions to the Medicare Benefit market, which is poised to change into the dominant means Medicare beneficiaries get their well being protection and care.
As well as, the standard beneficiary has a selection of 24 Medicare Half D stand-alone prescription drug plans for 2023, a second KFF evaluation finds, another than in 2022.
These findings are featured in two briefs launched by KFF right this moment that present an summary of the Medicare Benefit and Medicare Half D market for 2023, together with the most recent knowledge and key traits. Medicare’s open enrollment interval started Oct. 15 and runs by way of Dec. 7.
Medicare Benefit
Greater than 28 million Medicare beneficiaries – 48 p.c of all eligible beneficiaries – are enrolled in Medicare Benefit plans, that are principally HMOs and PPOs supplied by personal insurers. Enrollment is projected to cross the 50 p.c threshold as quickly as subsequent yr.
For 2023, a typical beneficiary has 43 Medicare Benefit plans to select from of their native market, together with 35 plans that supply Half D drug protection. In whole, 3,998 Medicare Benefit plans can be obtainable throughout the nation.
The common Medicare beneficiary can select from plans supplied by 9 companies in 2023, the identical quantity as in 2022. Even so, Medicare Benefit enrollment is concentrated in plans operated by UnitedHealthcare and Humana, which collectively account for 46 p.c of Medicare Benefit enrollment in 2022.
Two thirds (66%) of Medicare Benefit plans don’t cost an extra premium past Medicare’s customary Half B premium, up from 59 p.c in 2022. In 2023, almost all plans (97% or extra) supply some imaginative and prescient, health, telehealth, listening to, or dental advantages, although the scope of protection for these providers varies.
Half D
The common Medicare beneficiary has a selection of 24 stand-alone Half D drug plans for 2023, another than in 2022. The overall variety of Medicare Half D stand-alone prescription drug plans that can be supplied in 2023 is rising by 5 p.c to 801 plans. Fifteen companies supply the plans, the bottom quantity in any yr since Half D began.
The estimated common month-to-month premium for Medicare Half D stand-alone drug plans is projected to be $43 in 2023, primarily based on present enrollment, a ten p.c enhance from $39 in 2022. This price of enhance outpaces each inflation and the Social Safety cost-of-living adjustment for 2023. Within the stand-alone drug plan market, greater than 8 out of 10 enrollees subsequent yr are projected to be in stand-alone plans operated by simply 4 companies: CVS Well being, Centene, UnitedHealth, and Humana.
Common month-to-month premiums for the 16 nationwide stand-alone drug plans obtainable in 2023 are projected to vary from $6 to $111. Premiums are rising for 12 of the 16 plans, together with 4 plans with will increase exceeding $10.
Inflation Discount Act
Starting in 2023, underneath a provision within the Inflation Discount Act (IRA), Half D enrollees can pay not more than $35 per 30 days for lined insulin merchandise in all Half D plans, and can pay no price sharing for grownup vaccines lined underneath Half D. Additionally, starting in 2023, drug producers can be required to pay rebates for drug costs that rise quicker than the speed of inflation, which may assist to dampen price will increase for Half D enrollees.
The brand new legislation additionally caps enrollees’ out-of-pocket drug spending underneath Half D, as of 2024, and requires Medicare to barter costs for some medication, with negotiated costs first obtainable for some Half D medication in 2026. A latest KFF explainer summarizes these and different prescription drug provisions within the Inflation Discount Act.
Along with these two new Medicare Benefit and Half D analyses, KFF has up to date its assortment of often requested questions about Medicare Open Enrollment to assist beneficiaries perceive their choices in the course of the annual open enrollment interval. Our up to date overview of Half D has extra details about Medicare’s prescription drug profit in 2023 and the IRA modifications over time. Current KFF analyses present {that a} comparatively small share of Medicare beneficiaries in contrast plan choices or switched plans throughout a latest open enrollment interval.