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Medicare 2021 Changes

If you have Original Medicare (Part A and Part B) or a Medicare Advantage plan, you want to know about the proposed changes for 2021. The Medicare 2021 changes will go into effect in the next benefit year. Go over the various changes, so you know what to expect in 2021.

Save More with Medicare Part D Prescription Coverage

Medicare Part D is bundled with some Medicare Advantage plans. Medicare beneficiaries also have the option of purchasing Part D prescription drug coverage. In the past, Medicare Part D plans had a wide coverage gap. This is commonly referred to as the donut hole. In 2019, beneficiaries reached the coverage gap after accumulating $3,820 in prescription drug costs. That included the amount they paid as well as the amount the plan paid. Once they reached the gap, they had to pay 37 percent of the cost for generic drugs.

Medicare is changing the coverage gap for 2021. You will never pay more than 25 percent for prescription drugs, even if you reach the gap. This change will go into effect in 2021 and will help you save quite a bit of money on prescription drugs.

Separating Drug Tiers

In a call letter, the Centers for Medicare and Medicaid Services (CMS) announced that it wants to separate generic and brand drugs in Part D formularies. The center believes this will reduce confusion and help save costs for enrollees. If this switch is made, people can easily identify generic drugs and save money. They will be less likely to choose brand-name drugs that are more expensive.

Opioid Changes

For the calendar year 2021, CMS wants to address the opioid crisis. It intends to have Medicare and Medicare Advantage plans cover opioid treatment programs and other treatment options. It is also going to surveil opioid prescribing practices. It also wants to make star rating changes to flag patients who use benzodiazepines and opioids. The new system will also track high-dosage opioid use. This will help providers protect patients.

Newly Eligible Beneficiaries Cannot Get Medigap Plans C and F in 2021

Medicare is phasing out Medigap Plans C and F. This is one of the most talked about Medicare 2021 changes. Medigap is a Medicare supplement insurance that covers some of the out-of-pocket costs associated with Original Medicare, and both Plans C and F cover the Medical Part B deductible. Starting in 2021, newly eligible beneficiaries cannot purchase Medigap plans that cover the Part B deductible. However, those who already have one of these Medigap plans can keep it.

While new beneficiaries cannot purchase Medigap plans that cover the deductible, there are still lots of options for those who want to reduce their out-of-pocket costs. They can still get Medigap plans that cover coinsurance costs and more. People who want to reduce their costs should talk to an insurance agent. The agent will help them select the right plan for their needs.

Supplemental Non-health Related Benefits for Medicare Advantage Plans

Medicare Advantage plans also have some changes coming in 2021. The Centers for Medicare and Medicaid Services announced that insurers can begin offering supplemental non-health related benefits to chronically ill Medicare Advantage members. This can include widening the hallways and installing ramps, along with other benefits. These changes should provide significant help to those who live with chronic illnesses and could improve the quality of their lives.

Fee for Service Updates

When looking at Medicare 2021 changes, it’s also important to consider the fee for service updates. Medicare wants to move to a global fee model instead of continuing with the fee for service system it has been using. This will likely take some time to implement in full. This new plan will offer some options to providers. While this is a step away from the fee for service system, it will not be completely eliminated in 2021. This change should not impact beneficiaries.

Choosing Coverage in 2021

While a lot will change in 2021, one thing remains the same. It is much easier to get the coverage you need when you speak to a licensed insurance agent. An agent can help you choose between Original Medicare and Medicare Advantage, and also help you select a Medigap supplement plan if needed. The agent will go over your coverage options and costs and make it much easier to make a decision.

Instead of trying to figure it out on your own, call an insurance agent today. Then, you will be certain to get the best coverage for your unique needs.

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