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:
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
$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).
Marketing for 2021 Annual Enrollment Period - Reminder
The 2021 Annual Enrollment Period (AEP) is just around the corner, starting on October 15th and ending on December 7th 2020. It is important to remember that The Centers for Medicare & Medicaid Services (CMS) do not allow any marketing for AEP to take place before October 1st. "Marketing" includes the following examples:
Contacting consumers to solicit an appointment.
Completing an enrollment application.
Hosting or advertising an event where 2021 plans will be discussed.
Talking about 2021 plan rates, options or benefits over the phone or during an appointment.
Obtaining a 2021 Scope of Appointment.
Sharing content regarding AEP on social media or via email.
Rule of thumb: If the purpose of the marketing activity is to eventually solicit an appointment for AEP, per CMS, it is NOT acceptable before October 1st 2020. If an agent is found to be marketing for AEP before October 1st, the agent could be penalized from the insurance carrier being marketed, or from CMS.
It is a good idea for agents to take this time before October 1st to work on certifications and becoming Ready to Sell for the 2021 AEP season. Save all marketing efforts for after October 1st.
The cost-sharing chart below covers what beneficiaries with Medicare Part D will pay for prescription coverage in each phase in 2021. This includes:
A deductible of up to $445 (this deductible varies by plan).
25% of the costs of their prescription drugs in the Initial Coverage Period (or up to $1,032.50 if they are in a plan with no deductible).
Up to $6,550 out-of-pocket expenses before the beneficiary reaches the Catastrophic Benefits Period. Once they hit this threshold, the Medicare beneficiary will pay either 5% coinsurance or $3.70 copay for generic medications, and $9.20 for brand-name drugs.
*Most Part D plans are not standard plans. This means calculating TrOOP costs during the initial deductible and ICP varies by plan. Source: 2021 Call Letter (p. 71) at: 2021 Call Letter.
CMS launched a remodeled website Thursday that consolidates its eight online consumer tools to one platform.
The redesigned site is an attempt by CMS to give users a more streamlined experience using its platform, called Compare tools.
CMS has published information online about healthcare providers and care settings for Medicare beneficiaries and their caregivers for more than 15 years. One of the elements for the hospital version to convey quality, the star ratings, has come under fire for producing inconsistent results and CMS recently proposed changes to the methodology as a result.
The eight different interfaces representing each care setting was confusing and cumbersome for users, according to CMS Administrator Seema Verma during a press call Wednesday. "The information will now be displayed in a modern streamlined design to make it as helpful as possible to users," Verma said.
The remodeled site, available on Medicare.gov, can now access users' location and a drop-down menu allows the consumer to select what type of provider they are looking for. Options are hospitals, nursing homes, home health, dialysis centers, long-term care hospitals, inpatient rehabilitation, physicians and hospice groups. A user can compare up to three providers using information about costs, location and quality data. The site is also compatible for use on smartphone and tablets.
CMS is seeking feedback from users about the upgraded platform. There is an online survey available on Medicare.gov for users. CMS will also seek feedback from provider stakeholders who treat Medicare beneficiaries.
Medicare Eligible Seniors Survey Findings: Technology, COVID-19, the 2020 Election and More...
Medicare Eligible Seniors Survey Results
One important takeaway from this survey is that seniors are embracing technology in new ways during the coronavirus pandemic. More than half of the respondents agreed that they have been using technology more during the pandemic.
Seniors are using technology for the following:
Healthcare: they are receiving virtual care through telemedicine, ordering prescriptions online and monitoring their health through wearables.
Information: they are using social media to stay informed on relevant news.
Communication: they are staying in touch with family and friends via texting, phone calls, video chat, and social media.
Entertainment: they are binge watching their favorite shows on smart TVs and streaming devices.
Technology Use Among Seniors in 2020
89% have a smartphone
83% use Facebook the most
75% have a smart TV or streaming device
73% use social media
68% have an iPad or other type of tablet
66% still have cable TV
61% feel they have embraced technology more during the COVID-19 pandemic
54% video chat with their kids and grandkids
50% have video chatted more since the start of COVID-19
47% binge watch shows
43% would wear a device that helped maintain appropriate social distance during the COVID-19 pandemic and alert others if they are too close
42% prefer talking on a cell phone as their method of communication
32% video chat with their friends
30% use social media to staying in touch with friends
29% prefer texting as their method of communication
28% monitor their health using a wearable (Apple Watch, Fitbit, etc.)
22% use social media to stay in touch with family
21% use social media for news
11% started using a smartphone or tablet during the pandemic
Life During COVID-19
64% have only left the house to go food shopping or to the pharmacy during COVID-19
62% have you seen their kids or grandkids in person since mid-March
54% have put off a dentist appointment because of COVID-19
27% have left their house whenever they wanted during COVID-19
2020 Medicare Usage and Preferences
97% say their doctor accepts Medicare
84% are not looking to switch doctors because they don’t accept medicare
69% with a Medicare Advantage plan are happy with it
51% think the age to be eligible for Medicare should be lowered to 60
39% look for a Medicare a plan that accepts their doctor
37% think seniors who have a Medicare Advantage plan and who contract COVID-19 are getting better care
26% look for a Medicare plan with low monthly premiums and copays
26% intend to switch from an Original Medicare to a Medicare Advantage plan in the next enrollment period
22% look for a medicare plan that has extra benefits (ie. dental, vision, hearing, fitness programs)
22% intend to change their prescription drug plan in the next enrollment period
20% plan to adjust their Medicare plan during the next annual enrollment period (Oct. 15 - Dec. 7)
12% used the special enrollment period to enroll in Medicare during COVID-19
89% think prescription drug prices are too high
36% spend more than $50 a month on prescription drugs
34% order prescriptions from an online pharmacy
66% are worried about out-of-pocket costs
62% are you worried about receiving an unexpected medical bill
50% have money set aside for their children or family to use for their health needs
36% have put off seeing a doctor because of cost
35% are worried about contracting COVD-19 because they may be hit with a surprise bill
68% of those who haven’t used telemedicine during COVID-19 say its because they haven’t needed to
58% have used telemedicine just once during COVID-19
44% have used telemedicine during COVID-19
43% intend on using telemedicine once COVID-19 passes
30% have used telemedicine once a month during COVID-19
10% used telemedicine before COVID-19
The 2020 Presidential Election
92% say lowering drug prices is an important topic in the upcoming election
84% haven’t seen the country more divided in their lifetime than it is now
68% say the economy and healthcare are the two most important issues to them in the 2020 election
58% will vote via mail-in ballot in November
42% will vote in person in November
The above results were gathered through an online poll of more than 1,000 Medicare eligible Americans ages 64+. The poll was conducted from July 20, 2020 to July 21, 2020, gleaning representative samples from each state based on population.
The coronavirus pandemic is impacting each person and family in a different way. Seniors are particularly impacted by the social distancing that is recommended for the over 60 population. Staying safe at home is changing how seniors interact with the world, but one thing hasn’t changed; seniors still rely on their agents.
Traditionally, seniors have worked closely with their agents to understand their health and life insurance options. And as Medicare offerings expand each year, it is crucial for seniors to understand the scope of their options so that they can make the right choice for their budgetary and healthcare needs.
During the coronavirus pandemic, seniors are unable to have vital in-person connections with their family and friends like they did before and are turning to technology solutions to help them stay in contact. In the same way, seniors are not able to meet with their brokers and agents for their vital consultations in the same way as they did before. As a result, many seniors are turning to technology to provide some clarity on their healthcare options. In fact,8 in 10seniors are researching their Medicare options on line.
With so many seniors researching their options independently online, it can lead brokers and agents to wonder whether seniors still need them to provide advice and recommendations? The answer is a resounding “Yes!” Seniors are predominantly interested in talking with an agent either in person or over the telephone, so much so that 56% of seniors either sign up for a health plan in person or over the phone.
Preferring to speak with a broker before making a final decision is understandable because health insurance can be confusing, and a trusted advisor can help resolve any outstanding concerns. By speaking directly with a trusted broker or agent, seniors can confirm their research, ask questions they were not able to resolve, and hear testimonials explaining the experiences of others in their area.
Brokers and agents are knowledgeable of their markets and can quickly and easily help resolve any outstanding concerns. In particular, 4 in 10 seniors are looking for a Medicare plan that accepts their doctor. Local brokers and agents are well versed in their local networks and can ensure that the client’s doctor is in the network.
While it’s important for brokers and agents to know that their clients value their services, how can those needs be met during a pandemic while most seniors are practicing social distancing? The good news is that seniors are becoming more tech savvy by adopting smart phones and tablets and using them for telemedicine appointments and to video chat with their grandchildren. This means that brokers and advisors should be able to contact their clients and have consultations over the phone or via video chat.
The social distancing required to combat the coronavirus pandemic has changed how we all interact. Although seniors are particularly impacted by the pandemic, they are embracing technology solutions to help them continue to interact with the world. While staying safe at home, seniors are relying on their agents and brokers to advise them on their health insurance options; go ahead and give your clients a call — they need you.
One Call Close Utilizing E-app, third-party data and an automated process, it is anticipated that most of your sales will be closed in just one telephone call, saving you valuable time and reducing follow-up.
Rapid Underwriting and Policy Issuance Even when full underwriting is required, it is anticipated that a determination will be made within minutes and if approved, the policy will be issued within 1 - 2 business days. Once approved, clients can expect to receive their policy and ID card within 7 - 10 days.
Company Values Nassau Re prides itself on maintaining three core values: service, commitment, and integrity: high quality service when questions arise or needs change; a customer commitment that will last a lifetime; and striving to earn and maintain customer trust.
Experience Nassau Life Insurance Company of Kansas was previously known as The Pyramid Life Insurance Company. Pyramid was formed in 1913 and has a long history of providing Medicare Supplement coverage – back to the introduction of Medicare.
Policy Holder Benefits With a Med Supp policy from Nassau, your clients can enjoy the following:
Nationwide coverage with the flexibility to see any doctor or go to any hospital in the U.S. that accepts Medicare
No referrals required for specialists
Household premium discount (If your client lived with at least one, but no more than three, other adults who are age 50 or older for the past year, they may be eligible for a 7% premium discount)
A 30-day free look period (If your client is not completely satisfied, the policy can be returned within 30 days for a full refund)
Guaranteed renewable: clients cannot be cancelled for health conditions or medical usage provided premiums are paid on time. The coverage will automatically increase if Medicare deductibles and coinsurances increase. Premiums may be modified to correspond with coverage changes
No paperwork to file: ID card is presented at time of service and the benefits are paid directly to your client’s doctor or hospital
We are pleased to launch Anthem’s Medicare products to our Agents
Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 106 million people, including more than 42 million within its family of health plans.
Annual Enrollment Period– This is the period from October 15 to December 7 when people can switch from Medicare Advantage to Original Medicare plus enroll in a Medicare Part D plan and apply for a Medicare supplement policy. Current Medicare supp policy owners do not need to take any action — coverage continues as long as premiums are paid on time.
General Enrollment Period-Every year from January 1 – March 31, people who didn’t enroll in Medicare during their Initial Enrollment Period and are not eligible for a Special Enrollment Period may enroll in Original Medicare during this time. Please note there will likely be late enrollment penalties.
Individual Enrollment Periods
Initial Enrollment Period (IEP)– The seven-month period when clients first can enroll in Medicare (three months before they turn 65, the month of their birthday, and the three months afterward).
Special Enrollment Period (SEP)– A time other than the Annual Enrollment Period or Initial Enrollment Period when people may join, change, or drop a Medicare plan. An SEP can be triggered by certain events such as a change in residence or leaving an employer’s group plan. Rules about when you can make changes and the type of changes you can make are different for each SEP.
Enrollment Periods at a Glance
Keep in mind, these are general guidelines and do not capture every situation possible, as it is nearly impossible to do here. These guidelines provide popular situations your client may be experiencing.