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How does the ‘hold harmless’ provision protect beneficiaries from Medicare Part B premium increases?
A provision known as the "hold harmless" provision protects many Medicare beneficiaries by essentially capping Medicare Part B premiums so increases aren't higher than Social Security's Cost of Living Adjustment (COLA).
Four ways to save money on your Medicare Part B premiums
Here's how to save money on premiums for Medicare Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium.
How are Medicare benefits changing for 2023?
Changes to 2023 Medicare coverage include a decrease in the standard Part B premium to $164.90 and a decrease in the Part B deductible to $226. Part A premiums, deductible and coinsurance are all increasing for 2023.
How will my Medicare prescription drug costs in 2023 compare with 2022?
Q: How will Medicare prescription drug costs change for 2023? A: There are several changes for 2023, including free vaccines under Part D, a $35 cap on monthly insulin costs, and changes to the Part D deductible and coverage thresholds.
2023 coverage: Medicare enrollment dates at a glance
Beyond your initial opportunity to enroll in Medicare plans, the federal government provides other windows for enrollment and plan changes each year.
(Note that the monthly premium for Part B also decreased for 2023, to $164.90/month for most enrollees. This is different from the deductible though; the premium is the amount you pay every month in order to have coverage, whereas the deductible is the amount you pay if and when you need medical care covered by Part B.)
The deductible for Part B was steady at $147 from 2013 to 2015 (this was lower than it had been in 2010-2011; see below for a list of Part B deductible amounts by year). It then increased to $166 in 2016 – far less than the $223 it would have been without the budget that Congress passed in November 2015, which included a loan for Medicare.
The Part B deductible increased again for 2017, to $183, and remained unchanged for 2018. For 2019, it increased slightly, to $185. And for 2020, it increased by another $13, to $198. The $5 increase in 2021 pushed it over $200 for the first time, with the 2021 Part B deductible reaching $203. And for 2022, the increase was fairly significant, pushing the deductible to $233.
The larger-than-average increase in the Part B deductible and premiums for 2022 was due in part to uncertainty about how Aduhelm, a new Alzheimer’s medication, might affect Part B spending. But costs for that (and other Part B services) ended up being lower than projected in 2022, allowing CMS to reduce the Part B deductible and premiums for 2023.
Some Medicare enrollees aren’t directly responsible for the Part B deductible:
But according to a Kaiser Family Foundation analysis, about 19% of Original Medicare beneficiaries only have Medicare Parts A and B. They don’t have Medigap coverage, employer-sponsored coverage, retiree health benefits from a former employer, or Medicaid. These enrollees — along with beneficiaries who have a Medigap plan other than C or F — have to pay the full Part B deductible if and when they need services that are covered under Medicare Part B. For 2023, that deductible is $226.
After the enrollee pays the deductible, Medicare Part B generally covers 80% of the Medicare-approved amount for covered services, and the enrollee pays the other 20%. But again, supplemental coverage can pay some or all of this 20% cost, leaving the enrollee with far lower out-of-pocket costs than they would have under Part B by itself.
These amounts are indexed annually, after being set by the Medicare Modernization Act in 2005:
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.