There are several changes coming to Medicare benefits for 2021:

  1. Every year, a cost-of-living adjustment (COLA) is announced. In 2020, benefits increased by 1.6% and for 2021, benefits will increase by 1.3%. This will result in an average increase of about $20 per month.
  2. The Medicare cost increases for 2021 are as follows
    • The standard monthly premium for Medicare Part B will be $148.50. This is an increase of $3.90 from 2020
    • The annual Medicare Part B deductible will be $203. This is an increase of $5.00 from 2020
    • The Medicare Part A inpatient hospital deductible will be $1,484.00. This is an increase of $76.00 from 2020
  3.  Medicare coverage options will be limited. Effective 1/1/2020, the Medicare Supplement plans that pay for the Medicare Part B deductible were no longer available to newly eligible enrollees. This will still be effective for 2021.
  4. CMS cut Medicare Part B physical and occupational therapy rates by 9%. The reduction in therapy payments was proposed to offset the increases in reimbursements for primary care physicians.
  5. Medicare Advantage enrollment is expected to increase to a projected 26 million.
  6. The Medicare Advantage maximum out-of-pocket is increasing to $7,550.00.
  7. The Medicare Part D maximum deductible is increasing to $445.00 for 2021.
  8. Medicare Part A coinsurance costs have increased
    • For hospitalization days 61 – 90, the participants will be responsible for a $371.00 coinsurance per day. This is an increase of $19.00 from 2020. Beyond 90 days, the coinsurance increases to $742.00 per day for your lifetime reserve days. You can read more about Lifetime Reserve Days here.
    • For skilled nursing facility admissions, the daily coinsurance for days 21 – 100 is $185.50 per day. This is an increase of $9.50 from 2020.
  9. Medicare coverage for COVID-19 includes:
    • Coronavirus testing
    • All medically necessary hospitalizations related to the coronavirus
    • A vaccine for coronavirus, should one become available will be covered by all Medicare Part D plans
    • Medicare expansion of telehealth services and virtual visits to increase access and meet patient needs due to the telehealth Public Health Emergency
    • The requirement that patients have a 3-day hospital stay before entering a nursing home to clear hospital resources for more critically ill patients is being waived
      REMINDER: Medicare Advantage Plan enrollment is expected to rise. Always make sure your front office staff gets the correct insurance information for billing purposes. Initially billing to Medicare Part B will result in a delay in payment.




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