Changes are coming to Medicare in 2021, and you’ll want to know all about them! Lucky for you, we have all the details. We’ll see budget updates, a reduction in drug costs, and more.
What is Medicare’s 2021 Budget and Plan
One of the many changes coming in 2021 is President Trump’s new budget to help reduce Medicare spending. The new budget estimates that spending will decrease by 7% between 2021 – 2030.
The 2021 budget expects to reduce Medicare spending by making several changes. One of these changes is to allow patients to see nurse practitioners as their primary caregivers.
Reimbursement rates to providers may also see a reduction. Although reducing reimbursement rates is a cause of controversy for many. Minimizing these rates may save you, the taxpayer’s money. On the other hand, patients could possibly lose access to some doctors.
What are Important Medicare Dates in 2021
As always, a new year brings essential dates that you need to know. Let’s go over these important dates now.
The next Annual Enrollment Period you’ll see begins October 15, 2020, and will run to December 7, 2020. Your coverage will take effect in 2021.
And Medicare Advantage plan’s Open Enrollment will run from January 1 – March 31.
Finally, the Medicare General Enrollment period will be January 1 – March 31.
How Much Will Medicare Cost You In 2021?
What are the Upcoming Changes to Medicare Advantage in 2021
The coverage of Medicare Advantage policies may be seeing some changes come 2021 as well. Advantage plans will be increasing their telehealth services and coverages.
Besides the increase in telehealthcare, members who live in rural areas may see the rise in available policy options.
CMS is giving Advantage plans the flexibility to include telehealth providers in specific areas.
Some of these specialties include:
- Primary Care
According to CMS Administrator, Seema Verna, “CMS’s rapid changes to telehealth are a godsend to patients and providers and allow people to be treated safely. The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”
Additionally, the new rule will give beneficiaries who have ESRD more coverage options with Medicare.
Before, ESRD patients could only enroll in Medicare Advantage plans under limited circumstances. The new rule implements changes made by the 21st Century Cures Act. It gives all ESRD beneficiaries a choice to enroll in a plan beginning in 2021.
Another significant change to Advantage coverage is the option for long-term care stays.
The Exclusion of Kidney Organ Acquisition Costs from Medicare Advantage Benchmarks
The 21st Century Cures Act revised the Social Security Act to let individuals with ESRD enroll in Advantage policies starting in January 2021. With this new option, the Cures Act also made similar payment changes in the Medicare Advantage and Fee-for-service programs.
On January 1, 2021, Medicare Advantage organizations are no longer responsible for organ acquisition costs of kidney transplants.
The costs will be eliminated from Advantage benchmarks and will have coverage under the Fee-for-service program instead.
Will There be a Reduction in Drug Costs?
President Trump’s budget calls on Congress to pass a “comprehensive drug pricing reform.” The reform estimates to reduce the federal deficit by $135 billion within the next ten years. President Trump made significant headway on the reduction in the cost of insulin.
In 2021, patients with Diabetes can join Medicare plans with caps on inulin pricing. Copays won’t cost more than $35 every month.
Are there Star-Rating Changes in 2021?
Another change coming in 2021 is how CMS is handling the 2021-star ratings. The Star Ratings help you compare health and drug plan quality.
CMS approved changes in March 2020 for the 2021- and 2022-Star Ratings. By doing this, the program can better support challenges stemming from the national health crisis.
CMS will end up using last year’s scores and ratings from 2020’s Star Ratings for the 2021 Star Ratings. With an impact on Part C star ratings, we’ll also see changes to Part C coverage.
The Updated New Hampshire Birthday Rule
New Hampshire will also see a new rule, come 2021. The bill will prohibit insurance companies from charging people who are Medicare-eligible with disabilities at a higher rate. Since New Hampshire will be adding this birthday rule, those under 65 will have the same premiums as those already 65.
What are the Physician-Fee Schedule Rule Updates?
The new year will also bring several changes to the physician fee schedule. The rule will keep proposed cuts to psychologists, physical therapists, and social workers intact. Starting in 2021, physicians will see payment cuts of 8%. The rule will cut payments to social workers and psychologists by 7%.
Need Help with Your Medicare Coverage
2021 is sure to bring many changes to Medicare. And with every year, we will likely see drastic improvements to health care and costs.If you’re new to Medicare, or an existing beneficiary, know that our team is here for you. Whether you’re interested in Medigap coverage or simply have questions – please call us today.
Our services are free, and we can provide you with an instant quote. Saving time and money has never been easier!
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