We are now amidst Medicare’s Annual Enrollment Period (AEP) where you can make changes to your coverage. Let’s speak today about what might be relevant for you and what’s new for this upcoming year of 2021.
Who is the Annual Enrollment period for?
The simple answer: everyone.
For those on Medicare Advantage plans: this is your chance to review your current plan in how the benefits and co-pays will change for the upcoming year. You can switch plans or choose to stay in your current plan.
For those on a Medicare Supplement plan, such as a Plan F, this is the time to look at your Part D Prescription Drug Plan (PDP).
Formularies change from year to year and should therefore be reviewed during this time. It could be that one of your drugs is on a higher tier this year and will cost you more money. Maybe your premium is going up and there is a different plan that could save you. You will not know the answer to this question without reviewing your benefits and comparing it to other plans.
Until when can I make changes?
December 7th is the last day of the Annual Enrollment.
What is new for 2021?
One of the most noteworthy changes for Medicare Advantage is if you have End-Stage Renal Disease (ESRD), i.e. kidney failure.
Previously, those with ESRD were barred from joining Medicare Advantage. Due to the 21st Century Cures Act, this ban has been lifted for 2021. Medicare Advantage plans now must accept you. This will affect more than 500,000 current Medicare beneficiaries!
Another big change for 2021 is for Diabetics. The government has imposed new regulations that cap monthly copays costs for Insulin at no more than $35. This will save you an average of $700 annually compared to previous years.
Important note: Not every plan will incorporate this program. If you have Diabetes and would benefit from this change you must check your plan. If your Medicare Advantage Plan or drug plan is not participating it might make sense to switch out to another plan that is.
The last change worth noting is the expanded Maximum Out of Picket Limit, or MOOP, to $7,550. This is an $850 increase from $6,700 in 2020.
This number is the most you could spend out of pocket per given year, in which afterward your plan will cover all costs. Keep in mind that many better plans will have a lower listed maximum than these numbers. This number is simply the government’s way of holding the insurance companies accountable once you’ve hit a certain level of spending.
If your plan is raising the limit this year to the increased $7,550, you should seriously consider making a switch.
I currently pay a premium for my MA plan and want to switch to a $0 plan. What’s the catch?
There is no catch. However, this just refers to your monthly premium. You still must pay your Part B premium which this year is $144.60 a month, (next year’s rate has not been released). You will also still have to pay co-pays and whatever cost-sharing the plan requires.
Having said that, you should absolutely be on a $0 premium plan. Every company, whether UnitedHealthcare, Aetna, Humana, etc. all offer these plans in multiple formats. Medicare Advantage plans have become so competitive that this has now become the norm. Nowadays paying a premium really doesn’t translate into a better plan.
There has never been a better time to be on Medicare Advantage. The coverage and benefits have only increased for 2021. Telehealth has only expanded in light of the COVID-19 pandemic. More and more doctors are accepting MA Plans as networks keep growing.
Make sure you are in the best possible plan for this coming year by giving me a call to discuss your coverage. Consultations are free of charge and can be done by phone, Zoom, or socially-distanced in person if desired.