Your Guide to 2021 Medicare Changes

The Centers for Medicare and Medicaid Services (CMS) reviews the policies of the federal health care plan each year. Among the 2021 Medicare changes taking effect on January 1 are adjustments to premiums and deductibles, enhanced coverage of acupuncture services, lower insulin costs and eligibility for those with end-stage renal disease.

Here's your guide to understanding key changes to Medicare in 2021.

Part A Premiums and Deductibles

Most people receive premium-free Part A coverage. If you're not eligible for this coverage, the monthly cost of purchasing Part A hospital insurance is either $259 or $471 in 2021, up from $252 or $458 in 2020. Your premium depends on the amount of Medicare taxes you or your spouse have paid.

The Part A deductible for inpatient hospital stays is set at $1,484 in 2021, up from $1,408 in 2020. This is the amount you pay for the first 60 days of hospital care. After this, the cost is $371 per day for the next 30 days, up from $352 in 2020.

Beneficiaries in skilled nursing facilities pay coinsurance after 20 days. In 2021, the daily cost is $185.50 for days 21 through 100, up from $176.00 in 2020.

Part B Premiums and Deductibles

The 2021 Medicare changes also affect Original Medicare Part B.

• Standard Part B monthly premiums are $148.50, up from $144.60 in 2020
• The annual Part B deductible is $203, up from $198 in 2020

Acupuncture Coverage

Medicare Part B now covers additional acupuncture visits.

Chronic low back pain is the only condition that's eligible for acupuncture coverage and is defined as:

• Lasting 12 weeks or longer
• Having no known cause; for example, it's unrelated to surgery, pregnancy, cancer or infectious disease

What's Covered

• Up to 12 acupuncture visits in a 90-day period
• An additional 8 sessions if your condition is improving. Medicare won't cover treatments if your doctor determines your condition isn't getting better or is worsening.
• No more than 20 acupuncture treatments per year

Beneficiaries pay a 20% coinsurance for eligible acupuncture treatments under Original Medicare.

Savings on Insulin

As part of the 2021 Medicare changes, supplemental benefits for insulin are now available through some Medicare Advantage and Part D plans. To receive this benefit, you must choose a health care plan that participates in the Part D Senior Savings Model.

These plans let you choose from different types of insulin and cap out-of-pocket costs at $35 for a one-month supply. This adds up to savings of $446 per year, making insulin more affordable for older adults.

To find a health care plan offering the Part D Senior Savings Model in your service area, use Medicare's online plan finder tool and select the insulin savings filter. 

Eligibility of Individuals With End-Stage Renal Disease 

As part of the 21st Century Cures Act passed in 2016, people with end-stage renal disease (ESRD) who are eligible for Medicare may enroll in Medicare Advantage plans as of January 1, 2021. 

Medicare Advantage Plans, also known as Medicare Part C, are offered through private insurers. You receive all of the Part A and B benefits provided by Original Medicare and some additional supplemental benefits such as prescription drugs, vision, hearing and dental. 

Some Medicare Advantage plans require you to use in-network health care providers. CMS recommends that before individuals with ESRD enroll in a Part C plan, they confirm whether the plan's network includes your:

• Current health care providers, such as your doctor and dialysis facility
• Future health care providers, such as transplant specialists

Complete Details on 2021 Medicare Changes

For the most current information about Medicare, visit www.medicare.gov. You can also contact Medicare at 1-800-633-4227 if you have any questions about 2021 Medicare changes.