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Changes Coming to Medicare in 2021


Medicare changes in 2021 include things like new benefits, cost changes, and more. Since Medicare changes annually, it can be hard to keep up. Lucky for you, we have all the details.

What Changes are Coming to Medicare in 2021

Changes to Medicare go beyond cost. In 2021, we see new benefits for those with End-Stage Renal Disease as well as Long Term Care patients. Also, Telemedicine is growing in availability. Before we go over all the specifics on benefit changes, let’s take a look at the cost of Medicare in 2021.

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How Much Will Medicare Cost in 2021

Medicare costs can vary from person to person. For example, those with higher incomes will pay more for Part B, this is the Part B Income Related Monthly Adjustment Amount. Considering how much Medicare has gone up in the past years, the 2021 increases are pretty low. We’ll go over the parts of Medicare and the cost increases in the information below.

What Will Part A Cost

Medicare Part A is free for most people. But, those that buy into Medicare could pay $471. And, those that paid 30-39 quarters could pay $259 per month.

But, the deductible still lingers as an expense. Mostly every year, the Part A deductible increases. In 2021, the deductible will be $1,484 for the year. That makes the increase only about $76 more than last year.

The inpatient hospital benefit period costs rose a little in 2021. For days 1-60 beneficiaries will continue to pay $0 each day during that benefit period. Now, days 61-90 grew to $371 each day. Finally, for days 91 and beyond you’ll pay $742 coinsurance.

Now, Skilled Nursing Facility copayments also saw an increase; days 21-100 will now cost $185.50 per day.

What Will Part B Cost

The Part B premium is increasing to $148.50 monthly, which is only $3.90 more per month than before. Then, the Part B deductible is going up to $203 which is only a $5 increase for the year. As you can see from the numbers, Medicare cost increases are reasonable.

What Does Medicare Advantage Look Like for 2021

Medicare Advantage plan premium costs are going down to an estimated $21 on average across the United States. Part C plans will be at the lowest premium price since 2007. Beneficiaries can also expect to see more plan options, even for those in rural areas. More options and lower costs sound like a huge win for beneficiaries opting for Part C insurance. In 2021, CMS is giving Advantage plans the flexibility to include telehealth providers in specific areas.

Some of these specialties include:

Before 2021, End-Stage Renal Disease 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 End-Stage Renal Disease beneficiaries a choice to enroll in a plan with the effective date of January 1, 2021.

In previous years, Medicare Advantage plans didn’t include coverage for Long-Term Care. Now, some Medicare Advantage plans will be offering coverage for Long-Term Care.

What is the Cost of Part D in 2021?

Premiums for Part D in 2021 average to about $41 a month. The initial deductible in 2021 is $445 for the year. Then, the initial coverage limit increased to $4,130. Also, the Out of Pocket threshold increased to $6,550.

During the Catastrophic Coverage phase, beneficiaries will pay a minimum of $3.70 for generics and $9.20 for all other drugs. Or, 5% whichever is higher.

While a lot of costs are going up in 2021 pertaining to Part D, insulin costs decrease.

What is the 2021 High Deductible for Medigap?

High Deductible Plan G, High Deductible Plan F, and Plan J have an annual deductible of $2,370 for 2021. Now, while F and J are both discontinued Medigap plans, the people currently enrolled will be liable for the deductible.

What is the 2021 Maximum Out of Pocket?

For Medicare Advantage, Maximum Out of Pocket limits can reach up to $7,550 for in-network services. Now, for out of network, you could have a MOOP of $11,300.

Those with Medicare Supplement Plan L have a $3,110 Out of Pocket Maximum. And, those with Medigap Plan K have a $6,220 Maximum Out of Pocket for the year.

FAQ’s

When were the 2021 Medicare premiums announced?
Medicare released the 2021 numbers in early November just before the new year.
When will 2021 Medicare Advantage plans be available for enrollment?
You can enroll in a 2021 Medicare Advantage plan as early as the Annual Enrollment Period.
Will there be changes to Medicare Supplement plans in 2021?
No, the best Medigap plans in 2021 are the same best options as before. Since Medigap plans don’t change benefits, it’s easy to find coverage that works for you.

How to Get Help with Your Medicare Coverage in 2021

Medicare is changing in 2021. If you’re new to Medicare, or an existing beneficiary, know that our team is here for you. Whether you’re interested in Medigap or simply have questions about Medicare, we can help.

Saving time and money has never been easier! Give us a call at the number above or fill out an online rate form to see the rates in your area now. Make sure to check out what factors impact your Medigap rates.

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

12 thoughts on “Changes Coming to Medicare in 2021

  1. I have had Medicare A, B, D coverage, plus Medicare Supplement Plan F for the last 7 years (age 66 – 73), and am happy with those benefits. Can I continue on same WITHOUT having to make some type of election/declaration for 2021? I have gotten a lot of correspondence recently pointing toward making an election one way or another, being a requirement.

    1. Hi Larry! The correspondence you’re receiving is more than likely your Annual Notice of Change letter from your Part D carrier. Your Part A, Part B, and Plan F benefits do not change annually. However, Part D benefits do. The letter explains your premium changes, as well as any benefit changes if any. You do not have to select anything if you don’t want to, your current plan will just renew on its own. However, you may find another Part D plan during the current Annual Enrollment Period that gives you the same benefits, with a lower monthly premium. I hope this helps!

  2. I totally agree. As a patient with serious medical issues, I do NOT want to discuss my condition with a PA (or whatever title they are given). Unfortunately, when you go to the doctors office, you get the PA instead. Once I requested the physician and had to wait another HOUR before he came in to see me. This is lousy treatment. Furthermore, I resent the fact that Medicare pays for the physician when all the patient got to speak with was the PA. If all I wanted to do was to speak with, or be seen by, a PA, I would enroll in one of those storefront or medical school clinics because that’s all you get in those places.

  3. I have an unusual circumstance I got married in 2017 I’m 66 and my husband 67, he has a different Medicare program from Blue Cross in WA STATE and pays 187.00 a month he can afford it I cannot I have Humana with 0 monthly. I make about 1400.00 a month with social security and a part time job in which I’m mostly cannot afford drugs on tier 2 or 3 I have inhalers for asthma, and last month my HUMANA drugs cost me 68.00 which left me with 1.69 in my bank account for two weeks. This totally makes me furious what in the heck can I do?? Medicaid won’t help because it goes off our combined income. So I’m literally screwed because it hurts me. Help please.

    1. Hi Ellen! The Annual Enrollment Period just started, so now is the time to compare your current coverage to see what other Medicare Advantage, MAPD, or Part D plans are available for 2021. If you use our Advantage and Part D comparison tool, you can see other options available in your area to see if you can find a plan with a lower premium that covers your medications better.

  4. My wife and I (81 and 77) use Blue Cross plan F from day 1, but now it is getting very expensive. I have major issues so it is working for me. What bothers me I won’t know what the premium will be until March of 2021. So I am looking to see who sells the same plan or close to. Advantage plans would not work for me. Your article gave me some knowledge about changes coming. Thank you

    1. Hi George! Yes, if you have major health issues definitely stick with Plan F or you could consider Plan G. The only difference between the two is Plan G won’t cover the Part B deductible. However, if you’re okay paying that out of pocket it should reduce your monthly premium. Most carriers offer Plan F, it just depends on where you live. The good thing is Medigap plans are standardized, so regardless of what carrier you enroll with the benefits will be exactly the same. The only difference between the carriers is the monthly premium. We can help you compare Plan F, as well as Plan G, side by side with the carriers in your area to see if we can get you a lower premium. You’ll most likely have to answer health questions to change carriers. However, if your health issues are something another carrier may deny you coverage over, your current carrier may allow you to switch to Plan G without your health impacting your approval odds to get you a lower monthly premium.

  5. I am deeply concerned about the rising cost of medicare, and the future of our medical care. My husband is still working at 73, but we still cannot afford a supplemental insurance for our medical costs. that being said there is a lot of times we don’t have tests or procedures done, even when ordered by our doctors. I have medical bills that are still not paid, so it makes it hard to just acquire more that I cannot pay. I really don’t know what the answer is, but we are really struggling trying to receive the care we need. There are so many people out there who want to offer different coverage to supplement our medicare, it’s hard to know who we really can trust.

    1. Hi Linda, I’m so sorry you’re having issues affording the medical care you and your husband need. Medigap plans are standardized by the federal government, it does not matter who you sign up with, the benefits will be the same. Assuming you have Part A and Part B, if you cannot afford a Medigap plan, a Medicare Advantage plan is a good alternative. While it may have higher out of pocket costs, the monthly premium can be as low as zero. We have a great video that explains the differences between these two options. Before enrolling, you’ll want to verify that your doctor is in the network of the plan. Also, if your income is low, you may qualify for both Medicaid and Medicare or possibly a low-income subsidy that will help cover some of your medical expenses. Give us a call if you have any additional questions. We’re here to help.

  6. Patients want to see doctors and not nurses when they need primary care! My patients are tired of being dumped with a midlevel! Both my parents have been injured by midlevels! Low standard of medicine! I find it interesting that veterinarians do not allow midlevels to see their animal patients! I am a Trump supporter but do not support patients being stuck with midlevels! My residents resent the midlevels and will not sign onto contracts in practices where they are present! We need to reimburse the primary doctors at the highest level! This is what patients want!!! Again many patients resent being dumped with a midlevel! Doctors spend many years in training and actually go to medical school! The midlevel( NPS, PAS) are basically shortcutters and avoid medical school, residency training and fellowship!

  7. I am greatly concerned with the changes regarding longer hospital stays after surgery and the need for rehabilitation/nursing facilities afterward.
    What happens to a single senior on Medicare who needs replacement joint surgery and rehab physical therapy for recovery for limb replacement when the patient is unable to secure help from friends or family? I am greatly frustrated that the times for hospitalization for surgeries have been cut at the same time longer requirements for in-patient rehabilitation has become harder to meet. Individuals with no help for recuperation are being forced to forego the needed surgeries. Denying the elderly needed assistance for recovery is inhumane!

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