Time is running out to change Medicare coverage


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There is not much time left to review Medicare coverage annually and adjust it by 2021.

The annual enrollment period for the program ends on December 7th. If you do nothing, you will be automatically enrolled in the current plan. However, if you pass on the opportunity to make sure there is a better opportunity, it may cost you.

“We are experiencing a number of circumstances where a change in plans will actually benefit policyholders,” said Danielle Roberts, co-founder of insurance company Boomer Benefits. “But sometimes we find that someone already has the best plan for him next year … and he can let the current plan automatically renew.”

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Simply put, this annual fall open enrollment period is for adding or changing coverage related to the Advantage Plan (Medicare Part C) and prescription drugs (Part D). You can switch, add, or discard these portions of coverage.

About one-third of the nearly 63 million people enrolled in Medicare, most of whom are 65 or older, choose to benefit through Preferential Plans offered by private insurers.

The remaining staff with the original Medicare: Part A (inpatient coverage) and Part B (outpatient care). These beneficiaries often combine this with a stand-alone Sub-Plan D and / or a Medicare Supplementary Plan (also known as Medigap), both of which are also offered by private insurance companies.

By 2021, the average beneficiary will have access to 33 benefit plans, according to research by the Kaiser Family Foundation. A total of 3,550 such plans will be available, an increase of 13% over this year. This means that even if you did not want another option before, by 2021 the situation may be different.

While insurers are regulated, specificities can vary greatly from plan to plan, county to county, and year to year. The changes may affect aspects of coverage, such as fees, deductibles, co-payments, covered services, and participating physicians and other providers.

Also keep in mind that the standard Part B monthly premium will be higher next year ($ 148.50, compared to $ 144.60 in 2020), as will the additional amounts paid by higher-income beneficiaries due to Part B and D fees (see the charts)

According to Roberts, whether through an Advantage plan or a stand-alone D-plan, it’s important to make sure the plan covers your specifications. Sometimes existing coverage remains the best option, but other times there is another plan that is less expensive.

“He doesn’t want to go to a pharmacy in January and discover a drug for which he paid $ 40, now $ 400,” Roberts said.

Other terms of coverage may change when you use Advantage Plans. For example, in 2021, the out-of-pocket limit will be $ 7,550, up from $ 6,700 this year, Roberts said.

If you select a preferred plan during your fall enrollment and later find that it is not appropriate, you can switch to another one between January 1 and March 31, or you can switch back to the original Medicare (and add a stand-alone Plan D).

You can check the price of medicines through the government’s Medicare plan finder.

Make sure your doctor, pharmacy, or preferred hospital is online, ask the insurance company that offers the plan, and confirm with your provider.