March 29, 2023


General Blog

6 Things to Know About Medicare in 2021

Medicare is an ever-evolving program. While some things remain the same from year to year, Medicare may have price and coverage changes. This year, 2021, is no exception. You should expect premium and deductible increases in the new year. However, the good news is that there are also some newly covered services and drug savings programs you should be aware of.

Original Medicare premiums and deductibles in 2021

Medicare is not free. Even those who qualify for premium-free Part A technically don’t get it for free. Although most people qualify for premium-free Part A, they are eligible because they paid Medicare taxes for at least ten years. Medicare taxes do not go towards your Part B premium, so you will have a premium for that once you enroll.

In 2021, the Medicare Part B premium is $148.50 per month. If you aren’t eligible for premium-free Part A and have to purchase it, your premium may be $259 or $471 in 2021.

Medicare Part A and Part B also have deductibles. The Part A deductible is per benefit period, while the Part B deductible  is per year. In 2021, the Part A deductible is $1,484, and the Part B deductible is $203. All of these figures increased from 2020.

Medigap 2021 plan options

Medigap plan options generally remain the same from year to year. However, as of January 1, 2020, only certain people are eligible to apply for Medigap Plan C and Plan F. If you became eligible for Medicare before 2020, whether you enrolled or not, you are eligible to apply for Plan C or Plan F in 2021 if it’s offered in your area.

However, if you became eligible for Medicare in 2020 or later, you cannot apply for Plan C or Plan F in 2021. You are eligible to apply for any of the other Medigap plans, such as Plan G or Plan N.

Medigap Open Enrollment

Most people are only guaranteed one chance to enroll in a Medigap plan without any health underwriting. This one-time window is called the Medigap Open Enrollment period. The window lasts for six months and starts on your Part B effective date. For example, if you start Medicare Part B on May 1, 2021, your Medigap Open Enrollment window starts the same day and ends on October 31, 2021.

After this window has closed, you’ll likely have to answer health questions when applying for a Medigap plan and could be denied coverage or charged a higher premium due to pre-existing conditions.

Medicare Advantage 2021 plan options

Medicare Advantage plans vary from year to year. New plans are always added to the mix, and old plans are revised for the new year. According to the Centers for Medicare and Medicaid Services (CMS), there are over 4,800 Medicare Advantage plan options for 2021. According to the Kaiser Family Foundation (KFF), on average, Medicare beneficiaries will have around 33 Medicare Advantage plan options each in 2021.

The new year also offers the lowest average monthly premiums for Medicare Advantage plans since 2007, according to CMS.

The 2021 Part D Senior Savings Model

In 2020, CMS announced a new drug savings program called the Part D Senior Savings Model. The model is set to take effect on January 1, 2021. Medicare beneficiaries had the option to enroll in a Model Part D plan during the last Annual Election Period. New Medicare beneficiaries will also be able to enroll in a Model Part D plan in 2021 during their Initial Enrollment Periods and other qualifying enrollment periods.

The Part D Senior Savings Model’s purpose is to limit insulin copays to $35 per month or less for covered insulin. Insulin-dependent Medicare beneficiaries should take advantage of this new 2021 program as soon as possible.

Telehealth and Medicare

Medicare has covered telehealth services for certain beneficiaries for some time now. However, in 2021, all beneficiaries will have access to the same telehealth covered services. This is due to the increased need for telehealth services in 2020 from the coronavirus.

In 2021, Medicare will continue covering telehealth doctor visits and other services as a standard Part B benefit. The Part B deductible and coinsurance apply. However, some doctors are offering to waive any cost-sharing for telehealth visits, at least during the pandemic.

When planning your Medicare enrollment, consider these updates in 2021. Researching your plan options well in advance will help you prepare for the new year.