What is the Medicare open enrollment period?

The Medicare open enrollment period is the time during which people with Medicare can make new choices and pick plans that work best for them. Each year, Medicare plans typically change what they cost and cover. In addition, your health-care needs may have changed over the past year. The open enrollment period is your opportunity to switch Medicare health and prescription drug plans to better suit your needs.

When does the open enrollment period start?

The Medicare open enrollment period begins on October 15 and runs through December 7. Any changes made during open enrollment are effective as of January 1, 2021.

During the open enrollment period, you can:

  • Join a Medicare Prescription Drug (Part D) Plan
  • Switch from one Part D plan to another Part D plan
  • Drop your Part D coverage altogether
  • Switch from Original Medicare to a Medicare Advantage Plan

Switch from a Medicare Advantage Plan

  • to Original Medicare
  • Change from one Medicare Advantage Plan to a different Medicare Advantage Plan
  • Change from a Medicare Advantage Plan that offers prescription drug coverage to a Medicare Advantage Plan that doesn’t offer prescription drug coverage
  • Switch from a Medicare Advantage Plan that doesn’t offer prescription drug coverage to a Medicare Advantage Plan that does offer prescription drug coverage

What should you do?

Now is a good time to review your current Medicare plan. As part of the evaluation, you may want to consider several factors. For instance, are you satisfied with the coverage and level of care you’re receiving with your current plan? Are your premium costs or out-of-pocket expenses too high? Has your health changed, or do you anticipate needing medical care or treatment?

As a starting point, listen to our interview on the STA Money Hour on maximizing your Medicare benefits. The open enrollment period is the time to determine whether your current plan will cover your treatment and what your potential out-of-pocket costs may be. If your current plan doesn’t meet your health-care needs or fits within your budget, you can switch to a plan that may work better for you.

How do you decide on what Medicare Plan is Right for you?

Source: 2019 Medicare Brochure “Choosing a Medigap Policy”

What’s was new in 2021 – Medicare Part B (hospitalization) premium and deductible caps

A provision of the short-term government spending bill recently passed by Congress and signed by President Trump limits potential Medicare Part B premium and deductible increases to 25% of what they would otherwise be. In April, the Medicare Trustees projected a 6% increase in the standard Medicare Part B premium, but stated that this projection was uncertain. Most Medicare costs for the following year are typically announced in late October or early November, so actual Medicare Part B costs for 2021 will not be available until then.

New and Expanded Benefits for 2021

Expansion of telehealth services. Medicare Advantage plans may now cover a wider range of telehealth and other virtual services, including virtual check-ins and E-visits that allow you to talk with your doctor or other health-care providers using an online patient portal.

Medicare Advantage for beneficiaries with End-Stage Renal Disease (ESRD).  Medicare-eligible individuals with ESRD are eligible to enroll in a Medicare Advantage plan during Open Enrollment. Plan coverage will start January 1, 2021.

Acupuncture coverage for back pain. Medicare now covers up to 12 acupuncture visits in 90 days for chronic low back pain.

Lower out-of-pocket costs for insulin. You may be able to join a drug plan that offers supplemental benefits for insulin (Part D Senior Savings Model). The copay for a 30-day supply of insulin will be $35 or less. Coverage will begin on January 1, 2021.

What will you pay in 2021 for Medicare Part B?

Medicare premiums, deductibles, and coinsurance amounts change annually. Here’s a look at some of the costs that will apply in 2020 if you’re enrolled in Original Medicare (Part A and Part B).

According to the Centers for Medicare & Medicaid Services (CMS), most people with Medicare who receive Social Security benefits will pay the standard monthly Part B premium of $153.30 in 2021. However, if your premiums are deducted from your Social Security benefits and the increase in your benefit payments for 2021 is not enough to cover the Medicare Part B increase, then you may pay less than the standard Part B premium.

People with higher incomes pay more than the standard premium. If your modified adjusted gross income as reported on your federal income tax return from two years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA), which is an extra charge added to your premium, as shown in the following table:

Source: www.medicare.gov

What will you pay in 2021 for Medicare Part B?

Other Medicare Part A and Part B costs in 2019 include the following:

  • The annual Medicare Part B deductible for Original Medicare is $203.
  • The monthly Medicare Part A premium for those who need to buy coverage will cost up to $471. However, most people don’t pay a premium for Medicare Part A.
  • The Medicare Part A deductible for inpatient hospitalization is $1,484 per benefit period. An additional daily coinsurance amount of $371 will apply for days 61 through 90, and $742 for stays beyond 90 days.
  • Beneficiaries in skilled nursing facilities will pay a daily coinsurance amount of $185.50 for days 21 through 100 in a benefit period.

Where can you get more information?

Comparing the Medicare coverage you currently hold to other Medicare plans can be confusing and complicated. It’s important to pay close attention to notices you receive from Medicare and from your plan. Take advantage of helpful resources available by calling 1-800-MEDICARE or by visiting the Medicare website at www.medicare.gov.


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Disclaimer:

Please remember that past performance may not be indicative of future results. Different types of investments involve varying degrees of risk, and there can be no assurance that the future performance of any specific investment, investment strategy, or product (including the investments and/or investment strategies recommended or undertaken by Avidian Wealth Solutions, LLC), or any non-investment related content, referred to directly or indirectly in this newsletter will be profitable, equal any corresponding indicated historical performance level(s), be suitable for your portfolio or individual situation or prove successful. Due to various factors, including changing market conditions and/or applicable laws, the content may no longer be reflective of current opinions or positions. Moreover, you should not assume that any discussion or information contained in this newsletter serves as the receipt of, or as a substitute for, personalized investment advice from Avidian Wealth Solutions, LLC. Please remember to contact Avidian Wealth Solutions, LLC, in writing, if there are any changes in your personal/financial situation or investment objectives to review/evaluating/revising our previous recommendations and/or services. Avidian Wealth Solutions, LLC is neither a law firm nor a certified public accounting firm and no portion of the newsletter content should be construed as legal or accounting advice. A copy of Avidian Wealth Solutions, LLC’s current written disclosure statement discussing our advisory services and fees continues to remain available upon request.

Financial Planning and Investment Advice offered through Avidian Wealth Solutions (Avidian), a registered investment advisor. Avidian does not provide tax or legal advice and the information presented here is not specific to any individual’s circumstances. To the extent that this material concerns tax matters or legal issues, it is not intended or written to be used, and cannot be used, by a taxpayer to avoid penalties that may be imposed by law. Each taxpayer should seek independent advice from a tax professional based on his or her circumstances. These materials are provided for general information and educational purposes based upon publicly available information from sources believed to be reliable—we cannot assure the accuracy or completeness of these materials. The information in these materials may change at any time and without notice.

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