Every year, Medicare Advantage plans change slightly. These changes can be confusing, which is why we’ll be explaining all the Medicare Advantage changes you’ll experience in 2023.  

First, what is Medicare Advantage?  

Medicare is federally-funded health insurance, designed to get you the care you need at a lower cost. Medicare Advantage gets you more coverage than Original Medicare—for example, your Medicare Advantage plan will often cover prescription drugs, while Original Medicare plans won’t. 

What do Medicare Advantage plans typically cover? 

Medicare Advantage usually covers all three Medicare Parts: 

  • Medicare Part A: Covers hospitalizations. You usually won’t pay a premium for this, however, there’s a small chance you won’t qualify for premium-free Part A. If that’s the case, you can purchase premium-free Part A. 
  • Medicare Part B: Covers medical insurance (non-emergency). Every Medicare Advantage enrollee pays a monthly premium for Part B.  
  • Medicare Part D: Covers prescription drugs. Only some Medicare Advantage plans offer this coverage.  

Medicare Advantage changes in 2023 

Here are the changes to Medicare Advantage plans that you should be aware of: 

1. Cost 

In 2022, the average Medicare Advantage enrollee paid $19 per month. In 2023, the average monthly premium for Medicare Advantage enrollees is decreasing to $18 per month. This means you’ll be paying less for the same great coverage.  

The lower costs are a result of the Biden-Harris Administration and its efforts to make healthcare more affordable. “Thanks to President Biden’s Inflation Reduction Act, millions of Medicare enrollees will have lower prescription drug costs and improved benefits when they sign up this year,” said HHS Secretary Xavier Becerra. 

2. Maximum out-of-pocket limit (MOOP) 

In 2023, the Medicare Advantage maximum out-of-pocket limit (MOOP) will increase to $8,300, from $7,550 in 2022. This means that after you spend $8,300 on Medicare services, your plan will cover the rest of your covered care costs for the rest of the year. 

However, most Medicare Advantage plans have lower out-of-pocket limits than the established maximum. Ask your insurer what your out-of-pocket limit is.  

3. Expansion 

Depending on what state you live in, your access to Medicare Advantage plans are limited. This may have caused problems for you in the past, but in 2023, five major Medicare insurers are planning to expand into new states and counties. You’ll have new options from: 

  • Aetna 
  • Cigna 
  • Elevance Health (which used to be known as Anthem Inc.) 
  • Humana  
  • UnitedHealthcare 

The expansion of Medicare Advantage insurers will help more people get great coverage.  

4. Drug coverage 

If your prescription drugs are covered, you’ll see a two important changes to your coverage in 2023: 

  1. For certain types of insulin, you’ll pay no more than $35 per month.  
  2. The Advisory Committee on Immunization Practices (ACIP) recommends certain vaccines, and all of these will be free. These include: COVID-19, HPV, measles, polio, smallpox, and more 

With the changes to Medicare Advantage drug coverage, you can expect to save money.  

Quick summary 

Here’s a summary of all the 2023 Medicare Advantage changes:  

  • The average monthly premium will be $18.  
  • The maximum-out-of-pocket limit is increasing to $8,300. 
  • Medicare Advantage plans will be offered in more states and counties. 
  • Insulin costs will be capped. 
  • Recommended vaccines will be free. 

Ōmcare engages with Medicare plans   

Ōmcare is actively engaging with Medicare Advantage plans to help bring technology into your home as part of the costs you already pay. Our goals are to increase healthcare access, improve health outcomes, and maximize care for what you already pay. 

Learn more about how we partner.