The Centers for Medicare and Medicaid Services (CMS) announces any Medicare changes before the new year arrives. Due to the coronavirus pandemic, Medicare made some adjustments that carried over into 2021. There are other changes new to Medicare in 2021, such as an increase in Medicare’s cost and access to services seniors didn’t have before. Let’s first discuss the new Medicare costs for 2021.
New Medicare costs
Original Medicare does come with a cost, which increased in 2021. Many beneficiaries believe that Medicare is free of charge, which could be due to most beneficiaries getting Part A for $0. However, it’s not technically “free.” Medicare also has other costs besides premiums, such as deductibles, coinsurance, and copayments.
Medicare Part A covers inpatient care inside the hospital, skilled nursing facility, and hospice. Many Medicare beneficiaries do not pay a premium for Part A due to the beneficiary or their spouse paying FICA payroll taxes for ten years (40 quarters). By paying payroll taxes for ten years, you are funding your Part A premium.
If you did not work in the United States, but you qualify for Medicare, you will pay $471 per month for Part A. When you are an inpatient at the hospital, you will pay the Part A deductible, which increased to $1,484 in 2021. Once you have paid the Part A deductible, Medicare covers the allowable charges for 60 days as an inpatient.
Part B covers outpatient services and preventative care for services like doctor’s visits, vaccinations, ambulance rides, and physical therapy. You cannot opt-out of the Part B premium due to work history. Unless you have Medicaid, you will pay the premium of $148.50 for Part B in 2021. However, if your income was greater than $88,000 two years ago (2019), your Part B premium will likely be higher.
You will also pay the Part B deductible of $203 before Medicare provides cost-sharing for outpatient services. However, some minor changes have been made to Medicare Part B’s cost-sharing to help seniors fight the coronavirus.
Medicare covers coronavirus treatment
The coronavirus is a respiratory disease that has affected senior citizens and people with underlying health conditions the most. Medicare had to adjust its coverage and cost-sharing to ensure seniors do not experience any roadblocks when getting the healthcare they need.
Medicare Part B covers both coronavirus tests, which are the nasal swab and antibody test. If these tests are administered at a hospital, doctor’s office, laboratory, or drive-thru, Medicare will waive the Part B deductible and coinsurance.
The FDA has approved two coronavirus vaccinations for emergency use in the United States, which are Pfizer-BioNTech and Moderna. Both vaccines are being dispersed in phases to help combat the coronavirus. If you receive either of these vaccinations, Medicare Part B will cover the cost at 100%.
Therefore, you will not have any out-of-pocket costs for a coronavirus test or vaccine, as they are both covered fully under Medicare Part B.
Telemedicine available to all beneficiaries
Telemedicine is a technological software that allows you and your doctor to see and speak with one another virtually. There is not any special equipment for telemedicine services. Most telemedicine services involve you downloading an app on your computer or smartphone for you to be able to speak with your doctor through a secure connection in real-time.
Through telemedicine services, a doctor can treat common conditions, prescribe medications, and order lab tests, just as a doctor would at an in-person visit. In the past, Medicare only covered telemedicine in certain situations for people in rural areas.
Thankfully, Medicare adjusted these limitations, so all seniors have access to this service. Seniors can now receive the virtual healthcare they need without the risk of exposure to the virus, regardless of their location.
Medicare Part B covers telemedicine appointments for doctor’s visits, consultations, psychotherapy, and other specific medical and health services. In previous years, beneficiaries would be subject to the Part B deductible and coinsurance amounts for a telemedicine appointment. Doctors can now waive the Part B copayments or coinsurance for telemedicine visits, if they wish.
However, if a doctor decides to waive the Part B coinsurance for one patient’s visit, the doctor must waive it for all patients. In other words, a doctor cannot waive the coinsurance for one patient but charge the next.
Learning what’s new in Medicare for 2021 is important; that way, you can become familiar with Medicare’s costs and services that you have access to. If you need assistance in learning what services or benefits you can obtain, reach out to a licensed Medicare broker, as most can be helpful guidance.