Healthcare Educators


What to Expect from Medicare in 2021

by | Aug 24, 2020

The fall open enrollment period for Medicare starts on October 15. To prepare, it’s smart to start thinking about what you want out of your 2021 plan. Here’s what to expect from Medicare in the coming year.

A Wider Range of Benefits

CMS has eased restriction on what Medicare Advantage plans are allowed to offer. As a result, plans can provide more non-medical benefits. Although the new rules first went into effect for plan years 2019 and 2020, some carriers might still be adding new benefits, and carriers with these new benefits may be expanding into new areas. In 2021, look for new benefits that might help you.

More Telemedicine

New rules also let Medicare Advantage plans expand telemedicine option.

Telemedicine was already becoming more popular before the pandemic, but the ongoing need for social distancing has made it a very important benefit. Original Medicare also got a telemedicine expansion in response to the pandemic, and although it was supposed to be temporary, there’s a push to make it permanent.

Many people who try telemedicine enjoy the convenience and don’t want to give it up. According to Fierce Healthcare, a survey of Medicare Advantage enrollees who used telehealth found that 91% said they had a favorable experience.

Expect telemedicine to continue to be a hot benefit option in 2021.

Options for People with ESRD

In the past, people with end stage renal disease (ESRD) typically could not join Medicare Advantage plans. A new rule is changing this starting in 2021. As a result, Medicare enrollees with ESRD will have more plan choices for the coming year.

More Affordable Insulin

The high cost of insulin has been a major problem for the millions of Medicare enrollees with diabetes. Starting in 2021, it looks like this will be changing. CMS says that more than 1,750 standalone Medicare Part D and Medicare Advantage plans with prescription drug coverage will offer insulin with a maximum copay of $35 per month. This is expected to result in an average out-of-pocket savings of $446.

Not all plans are participating in this new model, so Medicare beneficiaries with diabetes should look at insulin costs carefully when comparing 2021 plan options.

Premium Costs May Change

Every year, the premiums that Medicare enrollees pay for coverage are subject to possible increases, although sometimes the average premiums for Medicare Advantage and Medicare Part D plans actually go down.

CMS has announced that the average basic Part D premium will be approximately $30.50 in 2021, making it the second lowest Part D average basic premium since 2013, just behind the 2020 average.

Need Medicare guidance? PTT’s licensed agents are at your service. Contact us to learn more.