Age Spots: Medicare News for the New Year

By Jackie Dover

As always, there are some changes for Medicare for the New Year. With the overall costs of medical care rising, Medicare costs are also increasing. The standard Medicare Part B premium is increasing $3.90 to $148.50. This amount is held out of your monthly Social Security check or paid to Social Security if you do not draw a Social Security check. The premium is what you pay to have Medicare coverage.

Medicare is also increasing the Medicare Part B deductible to $203. After you meet the deductible, Medicare typically pays 80% of the Medicare approved amount for most outpatient services. A deductible is the amount you must pay before Medicare begins paying for your medical care.

Most people do not have to pay a premium for their Medicare Part A because they have paid into the Medicare system by working or they draw off a spouse who worked. For those that do pay a premium for Part A it is also increasing for 2021. The increase depends on how many quarters you have worked in your lifetime. For those who worked 30-39 quarters the standard premium is $259, for those who worked less than 30 quarters the standard premium is $471 monthly.

The Medicare Part A deductible has also increased for 2021; it will be $1,484 per benefit period. A benefit period begins when you are admitted to an inpatient facility; it ends 60 days after you are released from a facility. Therefore, you could have multiple benefit periods in a calendar year.

If you have a supplement, some of these costs could be covered. Medicare Advantage plan costs will vary by plan. Low-income Medicare beneficiaries could get help paying for some of these costs also. The highest income for a single person to get help with the Medicare Part B premiums is $17,472 yearly for a single person with assets below $7,860 and for a couple $23,520 with assets under $11,800.

On the opposite end of the income spectrum is those who have higher incomes and have to pay more for their Medicare. Income Related Monthly Adjustment Amount (IRMAA) is an extra charge added to the premium of high-income earners. IRMMA begins for a single person whose yearly income in 2019 was above $88,000 and above $176,000 for a couple, the amount owed for Medicare increases as the income increases. The Medicare Part B and Part D premiums are increased by IRMMA. Social Security looks at your income from 2 years prior to determine IRMMA, you can ask for an appeal or redetermination if you think the information is wrong or your circumstances have changed.

I have received several questions about how Medicare covers COVID. Medicare does cover the testing for the Coronavirus and it will pay if it is medically necessary for you to be hospitalized because of COVID. You would still be responsible for deductibles and co-insurance for the hospital stay.

With a vaccine for COVID, now available many wonder when it will be available to them and how much it will cost. In Missouri as with many other states health care workers who have direct patient contact and long term care residents and staff will have priority. The next priority group includes those who are high risk, which includes those who are 65 and older. So most Medicare recipients will be a priority, but it will still take time to get the vaccine. It is recommended that you continue to practice social distancing and safe practices while the vaccine is being rolled out. As for the cost, according to the Center for Medicare & Medicaid Services (CMS) the COVID-19 vaccine will be available to everyone for free, regardless of coverage status. They will not pay coinsurance, deductibles, or copayments. The vaccine will be federally purchased – funding through the CARES Act will pay for the vaccine. This is good news as we head into 2021. Let’s hope 2021 is a great year.

If you have any questions about Medicare or any senior issue, please call Aging Matters, 800-392-8771.

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