Healthcare Educators


Medicare News Roundup

by | Nov 6, 2020

The end of the year is a busy time for Medicare news, and 2020 has been an especially eventful year. There have been updates on the pandemic, as well as important announcements for 2021. Here’s what’s happening now.

2021 Low Income Subsidy Resource Limits

CMS has announced the 2021 resource limits for Medicare’s Low Income Subsidy (LIS), also called Extra Help, which helps qualified beneficiaries pay for prescription drug costs. The 2021 resource limits are as follows:

  • $7,970 if single for the full LIS
  • $11,960 if married for the full LIS
  • $13,290 if single for the partial LIS
  • $26,520 if married for the partial LIS

If the beneficiary notifies the Social Security Administration that money has been set aside for burial expenses, the limits will be adjusted by a pre-determined amount to reflect this.

In 2021, Medicare says that beneficiaries receiving the LIS will not pay more than $3.70 for generic prescription drugs and $9.20 for covered brand-name prescription drugs.

The Social Security COLA

The Social Security Administration has announced the cost-of-living adjustment (COLA) for 2021. People receiving Social Security benefits will get a 1.3% increase in their benefits. The average monthly benefit for retired workers was $1,523 before the COLA. After the COLA, it will be $1,543.

The COLA is calculated based on changes in the Consumer Price Index (CPI-W).

Fewer Medicare Advantage Enrollees Will Be in 4- or 5-Star Plans

In 2021, 77% of Medicare Advantage enrollees are expected to be in plans with four or more stars, according to Healthcare Dive. While this is still the majority of enrollees, it is lower than the 81% of enrollees who were in plans with four or more stars in 2020. Additionally, only 17% of people enrolled in standalone prescription drug coverage will be enrolled in a plan with four or more stars. A total of 28 plans will be awarded five stars.

Medicare and COVID-19

According to Fierce Healthcare, one in three Medicare Advantage plans will offer new supplemental benefits that are related to the pandemic in 2021. These benefits may include care and relief packages that contain items like masks and hand sanitizer. Additionally, 94% of Medicare Advantage plans will offer telehealth benefits for services covered by Medicare Part B.

CMS has also modified benefits in response to the pandemic, including the expansion of telehealth benefits. Becker’s Hospital Review reports that CMS added 11 new telehealth services that will be reimbursed during the COVID-19 pandemic on October 14. You can see Medicare’s list of covered telehealth services here.