Many older individuals in the United States depend on Medicare to pay for health care needs. It can be challenging to determine what’s covered under Medicare and how much it costs. To make matters even more complex, there are various changes to the Medicare system each year. For example, at the beginning of 2021, the Centers for Medicaid and Medicare Services issued a final ruling addressing Medicare Part C and Part D. This far-reaching rule is just one of several changes to Medicare. This article reviews some of the other important issues to consider about other Medicare changes that will occur in 2021.
The Four Parts of Medicare
Medicare is divided into four separate categories that pay for distinct health services. This includes:
- Part A. This category covers inpatient hospital stays, skilled nursing facilities, home health visits, and hospice.
- Part B. This category includes physician visits as well as outpatient service, preventive service, and some home health visits.
- Part C. Sometimes referred to as the Medicare Advantage Program, individuals can enroll in a private health plan and receive all Medicare including Part A and Part B benefits as well as Part D Benefits.
- Part D. This category covers outpatient prescription drugs through private plans that contract with Medicare.
Medicare Changes Due to the COVID-19 Pandemic
The spread of the COVID-19 pandemic led to several unprecedented changes to the Medicare system in 2020. Most of these changes have carried into 2021. For example, Medicare covers various costs associated with screening for, vaccinating against, and treating Covid-19. Additionally, Medicare has waived prior authorization requirements for Medicare Advantage as well as the requirements associated with skilled nursing facility care and Medicare certification for home health services.
Changes to Medicare Part A
While many people do not pay a premium for Medicare part A, people who do pay this amount will notice an increase in their premiums in 2021. For individuals who worked 30 to 39 quarters during their life, the premium will increase by $7 for a total of $259 a month. For individuals who worked less than 30 quarters during their life, the premium will increase by $13 for a total of $427 a month. Additionally, deductibles for Medicare Part A also increased in 2021. For each benefit period, the deductible has increased to $1,484 which is $76 more than it was in 2020.
Changes to Medicare Part B
Medicare part B covers important things like physician fees, outpatient services, medical equipment, and home health services. Premiums are based on income, which means that everyone will pay a different amount for this coverage. Premiums in 2021 for Medicare Part B, however, increased but less substantial than they did in 2020. Deductibles for Medicare Part B also increased to $203 a year in 2021, which is $5 more than it was in 2020.
Changes to Medicare Part C
Given that Medicare C costs are set by private companies, not a great deal changed in regards to federal laws this year. One major change regarding Part C, however, involves individuals who have end-stage renal disease. Following the passage of a law in Congress, individuals with end-stage renal disease can enroll in a broader range of Medicare Advantage plans in 2021. Before this law, many companies offering Medicare Advantage plans would not let a person enroll in these plans or would limit them to a chronic condition SNP if that individual had end-stage renal disease.
Changes to Medicare Part D
Medicare Part D is referred to as the prescription drug plan for Medicare. Similar to Medicare Part C, Medicare Part D plan costs change between providers, and premium costs are adjusted based on income. In 2020, the Medicare Part D “donut hole” was closed. This hole refers to a gap in the plan’s prescription drug coverage that occurred once the plan had paid out a certain amount for prescription medications in the same year.
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