With 2021 quickly approaching, we are always advising seniors to plan ahead with their health insurance.
You never know what your medical and financial needs might be like in the near future, so it is good to know what your options are and how different coverage plans might benefit you in the coming years.
While there always is the chance of small changes to the plan, it’s best to use our site to compare plans in your area and make sure you’re getting one that fits your needs the best.
We can tell you about some of the insurance providers that will be selling them, give you an idea of the cost and equip you to plan ahead well and to be informed when you do make that coverage decision for 2021.
Medicare Advantage Plans 2021 – 3 Big Changes
Well the Medicare Annual Election Period (AEP) for 2021 is nearly upon us. There are currently over 22 million people on Medicare Advantage plans and many of you will likely want to switch your plan or just get started on an advantage plan.
The Centers for Medicare & Medicaid Services (CMS) have announced three new big changes to Advantage plans for 2021, each helping to create a more positive experience and provide better benefits to Medicare Advantage plans in 2021.
The 3 big changes to Medicare Advantage plans in 2021 are:
Expanded Telehealth Services by providers to patients
People with end-stage renal disease are now allowed to enroll in Medicare Advantage plans
Medicare Part D updated initial coverage limits and donut hole closing
Expanded Medicare Advantage Telehealth Options
CMS has allowed for insurance providers to offer a far wider range of telehealth services now in 2021. This was a necessity due to the Covid-19 pandemic, and now members have the ability to receive outstanding care virtually from the safety of their own homes.
For those people who are unable to go visit their doctor easily or for very high risk individuals this is a fantastic option. The ability to use video conferencing over the internet allows for a great deal of flexibility, safety, and comfort for everyone.
Many telehealth sessions will be treated much like office visits in terms of billing and your insurance coverage. These sessions can include items such as diagnosis, evaluation, and treatment of symptoms.
Virtual check-ins will also be coverage using devices such as:
Patient portal uses
Medicare Advantage Plan 2021 Telehealth Services:
Neurobehavioral Status Exam
Care Planning for Patients with Cognitive Impairment
End-stage Renal Disease Enrollment into Advantage plans in 2021
Another big change in 2021 is the fact that those with end-stage renal disease are now allowed to enroll in the 2021 Medicare advantage plans. It’s great to have the addition of these coverage options that can help them.
This was implemented through the 21st Century Cures Act from Congress, and starting in January of 2021 the new bill allows individuals with end-stage renal disease (ESRD) to qualify for eligibility into Medicare Advantage plans.
Currently Advantage plans were only available to people with ESRD during open enrollment periods, so this is a great change.
Medicare Part D 2021 initial coverage limits and donut hole closing
You migh be familiar with the dreaded “donut hole” of Medicare Part D drug plans. This is when you’re required to pay a larger percentage of your drug costs should you reach a certain limit of spending.
In 2011 measures were put into place to eliminate the donut hole over a period of years. There is something called the “inital coverage limit”, which is an amount you must reach and then you are in the donut hole.
In 2020, this amount is $4020. With the new Part D drug plan change in 2021 this limit has been raised to $4130 making it slightly more difficult to reach the donut hole (A good thing!).
If you do reach the donut hole of Medicare Part D in 2021, discounts for brand name and generic drugs are 75%.
Compare Medicare Advantage Plans for 2021
Let’s start by talking about what Medicare Advantage plans cover for you.
There is some standardized coverage for these plans, but it really only applies to base coverage.
A lot of the Medicare Advantage plans will move beyond the base coverage to offer you more, and that kind of powerful, expansive coverage can do great job of taking care of you and leaving you with very few medical expenses left to pay out of your own pockets.
Medicare Advantage plans are very popular and have been for a few years now. Seniors are realizing just how economical they can be and how well they can cover people for their medical care.
Instead of signing up for multiple insurance plans and paying multiple premiums each month, seniors can simply opt for a more streamlined approach and get a Medicare Advantage plan that does the work of a few different plans.
Medicare Advantage Plans 2021
First of all, we want to tell you about the base coverage.
This is what every insurance carrier is required to include in their Medicare Advantage plans, whether they are selling a high coverage or a low coverage plan.
Medicare Advantage 2021 plans must include coverage for the majority of Medicare Part A.
That would be many inpatient services, such as hospital stays, medical tests, surgery, nursing care facility stays, rehab center stays and more.
The only medical expense relating to Medicare Part A not covered by the Advantage plan is going to be hospice care, as that will still be covered by Original Medicare.
Medicare Part B’s full coverage is included in Medicare Advantage plans as well.
This includes all outpatient expenses related to Part B, such as medical tests, some medications, doctor’s visits, ambulatory care and more.
All emergency care is included as well, covering you for ambulance transport, ER visits and other lifesaving treatment.
Those can be very expensive services, and having them covered by a Medicare Advantage plan is a very affordable way to deal with the unexpected and to keep your annual healthcare costs manageable.
Urgently needed medical care is covered by Advantage plans too.
It is part of the base coverage and is going to include any medical procedure or service (not already covered by these other parts of the plan) that your healthcare provider deems to be medically necessary.
That can entail a lot of services, and what it covers exactly will really depend on the situation.
As you can imagine, some medical services will be medically necessary at certain times in your life, whereas at other items they would be totally unwarranted.
Advantage plans often include coverage for a powerful prescription drug plan known as Medicare Part D.
This covers you in tiers, with some drugs being covered completely and others being covered only partially.
Part D is different from each insurance provider, so check the Part D plan that is included with the Advantage plan you are considering to ensure it will cover the medications you need to have covered.
You can also be covered for routine checkups for your hearing, your vision and much more by the Advantage plan you pick.
This can also include cover for prescription items like hearing aids and eyeglasses that your doctor recommends to you following the checkup. Keep in mind that these items are not required to be a part of every Advantage plan, so if you need them specifically, look for Advantage plans that include them.
Of course, you will pay less for just a basic plan that doesn’t include any of this additional coverage.
How much are you going to pay for Medicare Advantage in 2021?
We cannot tell you what the prices will be for that upcoming year yet because the insurers haven’t announced them yet.
We can tell you the average cost of an Advantage plan for 2020, though, which is about $140.
Prices start at $0 per month and go up to $300 or more.
This is only the monthly premium, and you will have the annual deductible to consider too.
Keep that in mind as you are figuring out your costs.
Medicare Advantage Plan Networks
Medicare Advantage plans for 2021 will not provide you with full coverage at every medical facility.
There will be some clinics, doctor’s offices and even hospitals where your Advantage plan will not be valid.
These would be medical facilities that are not part of your insurance carrier’s network.
That network is unique to each insurance provider.
The insurance companies have to do the work of contacting each medical facility and requesting that they honor the company’s plans.
No matter which insurer you sign up with, there will be some medical facilities where their plans are simply not accepted.
What do you do if you live outside of your carrier’s network and still want to be signed up for one of their Advantage plans?
You simply pick a suitable network option.
There are two main ones for you to pick from:
The PPO option will actually cover you outside of the network, so it is really handy for people who are having trouble finding network coverage or who travel a lot and are not sure where they will be when they require medical care.
PPO options offer you partial coverage outside of the network and full coverage on the network.
If you live on the network, then you can save money by going with the cheaper HMO option.
This covers you only on the network and will only offer you coverage outside your network when you have an emergency and are taken to an off-network facility because there is no other choice.
What do you do if you live outside of your carrier’s network and still want to be signed up for one of their Advantage plans?
Medicare Advantage plans are sold by numerous medical insurance companies right now, and many of those insurers will still be selling the same kinds of plans in 2021.
Let’s look at a few of the more notable insurance providers that will offer these plans for the coming years.
Humana Medicare Advantage Plans 2021
If you sign up for a Humana Medicare Advantage 2021 plan, then you will get something with a name like Humana Gold Choice, Humana Gold Plus or Humana Choice Pro.
These offer different levels of coverage for you, but you should remember that they all share the same base coverage that Medicare requires.
Humana offers plans with premiums as low as $0 per month, and they have an extensive network that includes a large percentage of the nation’s hospitals.
Aetna Medicare Advantage Plans 2021
Aetna Medicare Advantage plans for 2021 are often packaged with some great member perks.
This company ensures its customers get a lot of value for their money by adding in extra benefits like coverage for gym memberships, nonessential medical expenses, healthy living plans, medication drop off at home and more.
Blue Cross Medicare Advantage Plans 2021
There are a number of different names for Blue Cross Medicare Advantage 2021 plans.
They can be called Blue Advantage, Blue Saver, Blue Value or something else, but you should know that they tend not be priced very competitively.
Advantage plans sold through Blue Cross tend to have different names depending on the state, as there is usually a different company that is part of the larger BCBS organization handling insurance in each state.
Are you interested in one of the Medicare Advantage plans we have discussed? In order to sign up, you need to be eligible for Original Medicare.
You also need to be 65 years or older, most of the time. There are some medical conditions that could help you to qualify for enrollment earlier than age 65, and if you have questions about your eligibility, be sure to contact us and let us get you some answers.
You can enroll during the Open Enrollment period.
The Medicare Open Enrollment Period 2020
That is going to start on October 15th of 2020 and it will last until December 7th, 2020. This is the period you want to use to send in your application for an Advantage plan.
Trying to sign up outside of that window usually means you will be rejected, and you often have to wait until the next enrollment period the following year, if you miss the current one.
Once you do get approved, though, then your coverage will begin on the first of the next year- so on January 1st, 2021. Open Enrollment is a great time to upgrade to a higher coverage plan or just change your plan to something else.
You can also renew your coverage, sign up for a new plan or cancel your plan at that time, if you want. The changes will go into effect on the first day of the new year.
Open Enrollment usually falls on the same period each year, but you will want to check if anything has changed before you start applying for a Medicare Advantage plan.
Do You Need Medicare Advantage for 2021?
Is Medicare Advantage the right step for you?
We don’t know your medical situation or your financial needs, so we can’t tell you definitively until we talk to you.
We are happy to answer any questions that you may have and provide expert advice to get you closer to an informed decision that you can feel peace about.
If you want peace of mind, perhaps Medicare Advantage is right for you.
This high coverage plan type can cover you for so many medical expenses that you may not have to worry about your next trip to the hospital or doctor’s office so much.
You may only have to think about the medical side of the experience and not the financial side, and that can be a big, positive change for most people.
We know some seniors avoid going to the hospital or other medical facility for treatment simply because they are concerned about how much money it will cost and wonder how they will afford
that. If you are in that kind of situation, then Medicare Advantage is definitely worth a look.
It’s not for everyone, but every senior should be aware of what Medicare Advantage does for them and how it might fit into their financial and healthcare situation.
If Medicare Advantage isn’t the right choice for you, then there are others.
You may want to consider a Medicare Supplement or a standalone Medicare Part D plan.
Keep in mind that you cannot sign up for Medicare Part D on its own if it is already included in your Medicare Advantage coverage.
This is true of any current health insurance plan you have and any plan you are interested in signing up for.
You need to know how the two kinds of plans will interact with one another and if there will be any conflict.
Some health insurance plans simply are not compatible with one another.
You cannot be signed up for both plans at the same time and receive coverage from them both as well.
You will have to get rid of one before the other can be valid.
This is true of most employer and union medical insurance plans as well.
For any question about conflicting plans and what kind of plan you could sign up for, you can always talk to us.
We can help you figure out what your options are and what kind of plan might be a good fit for you.
Medicare Advantage plans for 2021 are going to be listed in a matter of months, so it is not a bad idea to start doing your planning now.
You can figure out what your needs are and get an idea of what kind of coverage you are looking for.
It’s very possible that one of the Medicare Advantage plans could be a big moneymaker for you in 2021.
Medicare Plans for 2021 - Other Options
Unless you were to just keep Medicare Part A and B only, there really are just a few different Medicare Plans in 2021 that you could choose to help you pay more than the average medical bills that Part A and B cover.
Of course advantage plans are one option, and you would still need to pay the Part B premium each month if you go that direction.
Another choice in Medicare plans for 2021 is a Medigap plan, or Medicare supplement.
These plans help pay the gaps, or expenses, that are found in both Part A and B Medicare however you do not have a network on a Medigap plan.
It simply follows Medicare wherever it goes which of course is nationwide.
Medicare Supplement Plans 2021
Another great option for people who are coming on to Medicare, or already have an advantage plan that you should consider are Medicare supplement plans for 2021.
These plans are entirely different than Medicare Advantage plans, and though they might appear slightly more expensive their coverage is second-to-none.
Medicare Supplement plans go right along Medicare and help pay the gaps, or expenses, that Medicare Part A and B do not pay.
Advantage plans are only required to provide as good of coverage as Part A and B, though they could cover more if they choose.
A supplement plan must pick up the differences as described in each plan letter, no questions asked. Your claims can never be denied.
No Network with Medicare Supplement Plans in 2021
One of the biggest benefits to have a Medigap plan is that there is no network to adhere to.
With advantage plans you must stay within your network to full coverage.
You must also get referrals if you want to see a specialist in-network.
With a Medicare supplement plan, there is no network as Medicare is a federal program.
This means you may use your coverage anywhere in the United States as long as the provider accepts regular Medicare.
2021 Supplemental Insurance for Medicare- Which Plans are Best?
If you are in fact interested in Medicare supplement plans for 2021 you’ll have to choose a plan. There are several different options when it comes to plan letters, as well as some recent changes that might affect you.
Medigap plans are lettered A-N, with each plan having it’s own set of benefits.
The good news is the top plans are all very close in coverage to help make your choice easier.
For years now, Medicare supplement plan F, G, and N have been the most popular.
In 2021 this will still continue, though Plan F is dropping in popularity because anyone new to Medicare on or after January 1st. of 2020 is not allowed to enroll in this plan.
Let’s cover the difference between each plan.
Medicare Supplement Plan F – 2021
Plan F was the most popular plan for years because it covered 100% of the gaps in Medicare.
This literally meant that if you had a Plan F you could walk into any doctor’s office that accepted Medicare, shown your Medicare and Plan F cards, and walked out with no bills.
No co-pays, no deductibles, no co-insurance, nothing to pay! Sounds great right?
Well, there’s a catch. Plan F not only has the highest premiums, it also now has the highest rate increases each year.
For these reasons many people enroll in a plan nearly identical to Plan F but with lower premiums and rate increases.
That plan, is Medicare Supplement Plan G.
Medicare Supplement Plan G – 2021
The only difference between Plan G and Plan F is one small deductible and who pays it.
This is the Medicare Part B deductible that everyone must pay, once-per-year. It has ranged from $135 -198 over the years, and once you pay this deductible (or your plan pays it) Medicare begins paying as well as your Plan G if you have it.
If you have a Plan F, your plan pays this deductible for you.
The only problem is you’re likely paying far higher premiums than the amount of the deductible each year.
This means you’re giving the insurance extramoney each year, to pay the deductible.
With your money!
This is why Medicare supplement plan G in 2021 will remain the most popular and millions of people will enjoy great benefits.
But another plan that has been out for several years is quickly becoming popular as well due to even lower premiums than Plan G.
It’s called Medigap Plan N.
Medicare Supplement Plan N – 2021
On Medigap Plan N you still pay the Part B deductible just like on Plan G.
The difference with Plan N is, after you meet this amount you might have a small co-pay each doctor’s visit. This co-pay will never be more than $20 though, and it’s not guaranteed that you’ll even have to pay one.
It all depends on how the doctor’s office codes your visit.
As well, on Plan N if you visit the emergency room and you are not admitted there will be a $50 co-payment that you must pay.
Plan N does not not cover what is called “excess charges”.
These are quite rare and in some states they’re not even allowed to charge them.