Monday, April 15

What’s New in Medicare for 2021?

Medicare is always changing to keep up with the status quo of the country’s healthcare system. The year 2020 brought many twists and turns with COVID-19, the election, and much more. Therefore, you should expect to see many new things in Medicare for 2021.

While some of these changes reflect the events of 2020, some of them are typical changes that tend to happen every year or new policies that have long been in the making.

Increased Medicare premiums, deductibles, and copays

Generally, Medicare increases costs, such as premiums, deductibles, and copays each year due to inflation and other factors. Fortunately, the new year’s increases aren’t as high as initially estimated because of the coronavirus pandemic.

The Centers for Medicare and Medicaid Services (CMS) determine the Part A, Part B, and Part D deductibles each year as well as the Part A and Part B premiums and copays. However, CMS does not determine the Part D premiums and copays as the plan providers set those costs. In 2021, the Part A, Part B, and Part D deductibles are $1,484 per benefit period, $203 per year, and $445 per year (can be lower depending on the plan), respectively.

The 2021 Medicare Part A premium, although usually $0 for most beneficiaries, is $471 or $259, depending on how many work quarters you have. Medicare Part B has a standard base premium that is set to $148.50 for 2021. The Part A daily copays you may pay for hospitals and skilled nursing facility stays also increased in 2021.

Elimination of underwriting for Medicare Advantage plans

There is a designated enrolling window that allows you to apply for a Medicare Supplement plan without having to answer health questions. However, no such window exists for Medicare Advantage plans. While you do have to apply for Medicare Advantage plans within specific timeframes, there is always one health question you have to answer on your application. That is, until 2021.

Until 2021, when you applied for a Medicare Advantage plan, you had to answer the question, “Do you have end-stage renal disease (ESRD)?” If you answered yes, you would be denied coverage under that Medicare Advantage plan. However, as of 2021, there are absolutely no health questions ever when applying for Medicare Advantage plans.

Insulin savings program

Insulin-dependent Medicare beneficiaries can receive insulin coverage through Medicare Part B or Medicare Part D, depending on how the insulin is administered. Unless you use an insulin pump to administer your insulin, you will get your insulin prescription through your Part D plan.

As of January 1, 2021, if you are enrolled in a Medicare Part D Senior Savings Model plan, your covered insulin will have a maximum copay of $35 per month throughout the entire year. According to CMS, this new program will save the average beneficiary over $400 a year.

Fewer restrictions for telemedicine coverage

In recent years, Medicare started covering telemedicine visits for beneficiaries who have suffered a stroke or have ESRD and lived in a rural area where access to specialists was limited. Medicare later updated this coverage to apply to any beneficiary who lived in a rural area. However, Medicare improved its telemedicine coverage again because of the coronavirus pandemic.

In 2020, Medicare updated its telemedicine coverage to apply to all beneficiaries regardless of where they live. This update is being carried over into the new year. In 2021, Medicare Part B will cover telemedicine doctor visits like any regular doctor appointment. Your Medicare Part B deductible and coinsurance will still apply.

Conclusion

While the general aspect of Medicare remains the same from year to year, it’s typical to see price increases, variations in coverage, and new policies put in force each year. This is why it’s so important to review Medicare’s changes each year so you’re prepared for how they will affect you.