Whether you are new to Medicare or have been enrolled for several years, it’s important to understand that Medicare plans change from year to year. The best time to join a Medicare health or drug plan is when you first get Medicare. Signing up when you’re first eligible can help you avoid paying a lifetime Part D late enrollment penalty. If you miss your first chance, you can sign up during Medicare’s annual Open Enrollment Period (October 15–December 7).
What is Medicare? Medicare is a National Health Insurance Program for:
- People 65 years of age and older.
- Certain persons with disabilities under the age of 65.
- People with end stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)
What does Basic Medicare cover? Medicare covers care that is deemed medically “reasonable and necessary” for the treatment of an illness or injury. It does not cover services that are considered “routine” or inpatient care that can be provided by people without professional skills/training.
The Four Components of Medicare. Medicare has 4 parts: A, B, C, and D and each covers different medical care and services.
Part A: Covers inpatient hospital care, hospice care, inpatient care in a skilled nursing facility, and home health care services.
Part B: Covers medical care and services provided by doctors and other medical practitioners, durable medical equipment, some outpatient care and home health care services. Individuals choose to become enrolled in Part B when they become eligible for Medicare and pay a monthly premium for that enrollment.
Part C: Also called Medicare Advantage, are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan which can include prescription drug coverage.
Part D: Covers some prescription drug expenses. Part D is available to any Medicare beneficiary who has Medicare Part A or Part B or both. Part D drug plans are sold by private companies. There is a monthly premium, an annual deductible & co-payments for each prescription and costs vary from plan to plan. Enrollment in Part D is optional.
What are the Changes Coming in 2021?
- The standard Part B premium will increase for 2021 but has been limited by a federal spending bill. It’s projected to increase to $153.30/month.
- The Part B deductible will likely increase above the current $198 for 2021 (up from $185 in 2019, and $183 in 2017 and 2018). The federal government has not yet announced the Part B deductible for 2021, but the numbers from previous years give us a good idea of the general ballpark range.
- Part A premiums, deductible, and coinsurance will also be higher in 2021. The exact amounts have not been finalized yet but will by late 2020.
- Medigap Plans C and F are no longer available for purchase by newly eligible Medicare beneficiaries.
- The income brackets for high-income premium adjustments for Medicare Part B and D are projected to start at $88,000 for a single person, and the high-income surcharges for Part D and Part B will increase in 2021.
- Medicare Advantage plans are available for people with end-stage renal disease as of 2021.
- The maximum out-of-pocket limit for Medicare Advantage plans is increasing to $7,550 for 2021.
- Part D donut hole no longer exists, but a standard plan’s maximum deductible is increasing to $445 in 2021, and the threshold for entering the catastrophic coverage phase (where out-of-pocket spending decreases significantly) is increasing to $6,550.
Medicare plans change every year and so do the medical needs of most people 65 and over. The Medicare enrollment period is October 15-December 7 highly recommends that all enrollees review their plans annually to be sure they have the one best suited to their needs. Please join us for a virtual presentation of Preparing for Medicare Open Enrollment – What You Need to Know on Thursday, October 29th at 11 am. You can register HERE for the event. Noble Horizon is also offering Medicare Part D Free Private Enrollment Assistance by appointment only on Thursday, November 12th. Please CLICK HERE for more information on how to schedule a time slot.