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Medicare Advantage Open Enrollment Period With Medicare’s Annual Enrollment Period (AEP) coming to an end, agents and advisors have spent the last month enrolling Medicare beneficiaries in Medicare Advantage (MA) and Prescription Drug Plans (PDP) for 2021. Come Dec. 7 – the date AEP ends – many agents and advisors will take some well-deserved time off to recharge and reconnect with family and friends. But smart agents and advisors know that another important enrollment period starts on Jan. 1: the Medicare Advantage Open Enrollment Period (OEP). Post-Enrollment Period It’s a simple step during the AEP process to ask clients the best ways to contact them for follow up. Make a note if they prefer a phone call, email or postal mail. Confirm and document their contact information and respect their decisions. Insurance professionals ensure their clients have the best coverage by keeping the lines of communication open. Developing a follow-up system is the best way for agents and advisors to make sure their client’s plan is working for them. Agents and advisors also need to follow through with their commitments. Some insurance professionals think the burden is on clients to contact them if there are issues with a plan. Agents and advisors shouldn’t risk losing clients due to poor customer service and lack of follow up.
During OEP, the beneficiary can:
Agents and advisors need to be keenly aware that Centers for Medicare and Medicaid Services (CMS) has put in place rigid rules regarding the communications they can have with clients about OEP. We are in the business of providing exceptional services to agents and advisors. It’s more than products and services. It includes giving you the valuable insights – such as contacting a client to make sure their plan is working for them. And, if necessary, use OEP as the time to help your clients change plans.
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2021
Medicare Parts A & B Premiums and Deductibles
On November 6, 2020, the Centers for Medicare & Medicaid Services (CMS) released the 2021 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs.
Medicare Part B Premiums/Deductibles
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
Each year the Medicare premiums, deductibles, and coinsurance rates are adjusted according to the Social Security Act. For 2021, the Medicare Part B monthly premiums and the annual deductible are higher than the 2020 amounts. The standard monthly premium for Medicare Part B enrollees will be $148.50 for 2021, an increase of $3.90 from $144.60 in 2020. The annual deductible for all Medicare Part B beneficiaries is $203 in 2021, an increase of $5 from the annual deductible of $198 in 2020.
The Part B premiums and deductible reflect the provisions of the Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337).
CMS is committed to empowering beneficiaries with the information they need to make informed decisions about their Medicare coverage options, including providing new tools to help them make those decisions through the eMedicare initiative. In addition to the recently released premiums and cost sharing information for 2021 Medicare Advantage and Part D plans, we are releasing the premiums and cost sharing information for Fee-for-Service Medicare, so beneficiaries understand their options for receiving Medicare benefits. As previously announced, average 2021 premiums for Medicare Advantage plans are expected to decline 34.2 percent from 2017 while plan choices, benefits, and enrollment continue to increase. The Medicare Advantage average monthly premium will be the lowest in fourteen years (since 2007). Premiums and deductibles for Medicare Advantage and Medicare Part D Prescription Drug plans are already finalized and are unaffected by this announcement.
Medicare Part B Income-Related Monthly Adjustment Amounts
Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. The 2021 Part B total premiums for high-income beneficiaries are shown in the following table:
Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
Medicare Part A Premiums/Deductibles
Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.
The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,484 in 2021, an increase of $76 from $1,408 in 2020. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2021, beneficiaries must pay a coinsurance amount of $371 per day for the 61st through 90th day of a hospitalization ($352 in 2020) in a benefit period and $742 per day for lifetime reserve days ($704 in 2020). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $185.50 in 2021 ($176.00 in 2020).
Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $259 in 2021, a $7 increase from 2020. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $471 a month in 2021, a $13 increase from 2020.
For more information on the 2021 Medicare Parts A and B premiums and deductibles (CMS-8074-N, CMS-8075-N, CMS-8076-N), please visit:
- (CMS-8074-N)- https://www.federalregister.gov/public-inspection/2020-25024/medicare-program-cy-2021-inpatient-hospital-deductible-and-hospital-and-extended-care-services
- (CMS-8075-N): https://www.federalregister.gov/public-inspection/2020-25028/medicare-program-cy-2021-part-a-premiums-for-the-uninsured-aged-and-for-certain-disabled-individuals
- (CMS-8076-N): https://www.federalregister.gov/public-inspection/2020-25029/medicare-program-medicare-part-b-monthly-actuarial-rates-premium-rates-and-annual-deductible
2020 & 2021 costs at a glance
Part A premium
Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $458 each month in 2020 ($471 in 2021). If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458 ($471 in 2021). If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252 ($259 in 2021).Part A hospital inpatient deductible and coinsurance
You pay:
- $1,408 ($1,484 in 2021) deductible for each benefit period
- Days 1-60: $0 coinsurance for each benefit period
- Days 61-90: $352 ($371 in 2021) coinsurance per day of each benefit period
- Days 91 and beyond: $704 ($742 in 2021) coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
- Beyond lifetime reserve days: all costs
Part B premium
The standard Part B premium amount is $144.60 ($148.50 in 2021) (or higher depending on your income).
Part B deductible and coinsurance $198 ($203 in 2021). After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment (dme)
Part C premium
The Part C monthly premium varies by plan.
Part D premium
The Part D monthly premium varies by plan (higher-income consumers may pay more).
