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September 29, 2022

Medicare premiums are about to decrease for the first time in 10 years

Daily Briefing

    CMS on Tuesday announced that Medicare Part B premiums will decrease for the first time in over a decade in 2023, citing "lower-than-projected spending on both Aduhelm and other Part B items" in 2022.

    Medicare premiums will decrease for the first time in over a decade

    In 2023, the standard month premium for Medicare Part B will be $164.90, down from $170.10 in 2022. In addition, the annual deductible will be $226 next year—a $7 decrease from $233 in 2022.

    Notably, Medicare Part B premiums have not decreased since 2012 when they decreased by 13.4% from $115.40 to $99.90 a month. However, even after premiums decrease in 2023, they will still be 11% higher than they were in 2021.

    Last year, monthly Medicare premiums for physician and outpatient services rose by almost 15%, primarily because the Covid-19 pandemic and potential coverage of Biogen's Alzheimer's drug Aduhelm added a "higher-than-usual degree of uncertainty" for projected Medicare costs in 2022, CMS said.

    "The 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm," CMS said.

    If the drug had been excluded from Medicare coverage, CMS noted that monthly premiums would have been $160.30 for 2022—which would have made 2023 premium costs a 2.8% increase.

    The Open Enrollment period for 2023 will begin on Oct. 15 and end on Dec. 7. CMS plans to release premiums and cost-sharing information for 2023 Medicare Advantage and Part D plans soon, Healthcare Finance News reports.

    Commentary

    Many experts anticipated a drop in premiums for 2023. When it was initially released, Aduhelm's annual cost was $56,000—but Biogen ultimately cut the drug's price in half to $28,200.

    Then in January, CMS announced that Medicare would only pay for Aduhelm for beneficiaries who are enrolled in qualifying clinical trials, prompting HHS Secretary Xavier Becerra to say that Medicare should revisit its premium recommendations for 2022 Medicare Part B. However, ultimately, "legal and operational hurdles" prevented that.

    Now, the "lower-than-projected spending on both Aduhelm and other Part B items" led to "much larger reserves" in the Supplementary Medical Insurance Trust Fund, which allowed premiums to decrease in 2023.

    On Tuesday, President Joe Biden celebrated the drop in costs for millions of Americans who receive Medicare coverage. According to Biden, the decrease will save each beneficiary more than $60 a year.

    "For years, that fee [for Medicare Part B premiums] has gone up," Biden said. "Now, for the first time in more than a decade, it's going to go down.  And millions of seniors and people with disabilities on Medicare, that means more money in their pockets while still getting the care they need."

    (O'Brien, CNBC, 9/27; Morse, Healthcare Finance News, 9/27; Luhby/Klein, CNN, 9/27; Aboulenein, Reuters, 9/27; Choi, The Hill, 9/27)

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