Making Sense of Medicare Advantage Coverage for 2023

As the world continues to evolve and change, so too do the healthcare options available to us. One of those changes is coming to Medicare advantage plans in 2023. With so much information available out there, it can be difficult to make sense of it all. Fortunately, this article will provide a comprehensive overview of what you need to know about Medicare Advantage 2023

Medicare Advantage is a type of health insurance that provides coverage for the services covered by Original Medicare (Parts A and B). It also covers additional services such as vision, dental, hearing aids, and more. Medicare Advantage plans are offered by private insurers and can vary in cost and coverage. 

What’s Changing in 2023? 

Starting January 1st, 2023, a new rule from the Centers for Medicare & Medicaid Services (CMS) will go into effect that requires all MA plans to offer basic coverage for prescription drugs. This means that MA plan participants will no longer have to pay out-of-pocket costs for their prescription medications. The rule also states that these plans must cover generic drugs at least 50% of their cost and brand name drugs at least 35% of their cost. This will help reduce the financial burden on those who require costly medications on a regular basis. 

Additionally, CMS has announced that they are introducing “Value-Based Insurance Design” (VBID) systems into certain MA plans starting in 2021. These systems allow insurers to tailor plan benefits based on individual health needs and risks They may also offer incentives such as lower premiums or copays for specific services or treatments if they are deemed beneficial for improving an individual’s overall health status or managing chronic illnesses like diabetes or hypertension. 

How Can I Prepare? 

The best way to prepare for any changes with your healthcare coverage is to stay informed and know what your options are come January 1st 2023. Start researching different MA plans now – compare their premium costs, deductibles, copays/coinsurance amounts, and other features such as prescription drug coverage – so you can make an informed decision when the time comes. You should also talk with your doctor about any existing medical conditions or treatments you may need so they can help guide you towards plans that best meet your needs. Additionally, if you are already enrolled in an MA plan you might want to consider switching prior to December 31st 2022 as current rules may be less generous than those taking effect after January 1st 2023 . 

Conclusion: In summary, due to changes from CMS starting January 1st 2023 all MA plans must provide basic coverage for prescription drugs including 50% coverage of generic drugs and 35% coverage of brand name drugs . Additionally VBID systems will be offered allowing insurers to tailor benefits based on individual health needs and risks . To prepare yourself start researching different MA plans now , talk with your doctor ,and consider switching prior December 31st 2022 if necessary . Doing this research now gives you plenty of time before the changes take effect giving you peace of mind when it comes time select a suitable plan .