2020-2021 Medicare Open Enrollment in Tampa Florida
2020-2021 Medicare Open Enrollment in Tampa Florida
Medicare Enrollment Period 2021, also known as the Medicare OEP 2021, runs between October 15, 2020, and December 7, 2021.
During this annual enrollment period, individuals who qualify for Medicare can renew or change their Medicare policies.
For instance, if you have an Original Medicare plan but want to switch to a Medicare Advantage plan, you can do so during this annual open enrollment period.
Do you have a Medicare Prescription Drug (Part D) or a Medicare Advantage plan? Every year, these plans can change the list of prescription medications they will cover, known as the plan formulary.
That means even if you are taking the same medications, the amount you pay for your medications may change in 2021.
The plans’ premiums, deductibles and co-pays can also change each year.
What can people do about this?
All Medicare beneficiaries should check their coverage each year during Medicare’s annual Open Enrollment Period, which runs Oct. 15-Dec. 7.
This is the time of year to find out if your current plan will cost you more, or less, than other plans in 2021. If it is no longer the best plan for your medications, this is the time to make a switch to a plan that will suit you better.
Make sure you will have appropriate coverage for your medications in 2021.
What is Open Enrollment?
Open Enrollment is the yearly period when people can enroll in a health insurance plan.
Open Enrollment runs from November 1, 2020 to January 15, 2021.
For coverage beginning January 1, 2021 you must enroll by December 15, 2020. Outside the Open Enrollment Period, you generally can enroll in a health insurance plan only if you qualify for a Special Enrollment Period.
What is Medicare in Florida?
Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease (ESRD). Medicare plans cover a comprehensive set of health services, but different sets of services are split among the different parts of Medicare, including Medicare parts A, B, C, and D.
What is Original Medicare in Florida?
Original Medicare is managed by the federal government and includes Medicare Parts A and B. To qualify for Original Medicare, you must be 65 or older, have a qualifying disability, or have End-Stage Renal Disease (ESRD).
Medicare Part A
covers inpatient care, such as treatment received in a hospital, nursing facility, and limited home health services.
Medicare Part B
covers services and supplies that are provided in an outpatient setting. It also covers prescription medications that are administered in a doctor’s office or hospital. It does not cover prescription medications that are typically taken at home.
What is Medicare Part D?
Medicare Part D is managed by private insurers and provides prescription drug coverage. A Medicare beneficiary must have a Part A or Part B plan to qualify for Part D coverage. While most medications are covered under Medicare Part D, there are some drugs that are only covered by Medicare Part B (e.g., antigens, hemophilia clotting factors).
Medicare Advantage (MA), also referred to as “Part C,” is a Medicare health plan offered by private insurers, rather than the government. MA plans generally must offer coverage benefits equal to those provided by Original Medicare (i.e., inpatient care and outpatient services, supplies, and prescriptions). To qualify for a Medicare Advantage plan, you must be 65 or older or have a qualifying disability and live within the plan’s service area. If you have ESRD, you may not qualify for most MA plans.
What are the differences between Original Medicare and Medicare Advantage plans?
With Original Medicare plans, you will receive a red, white, and blue card that you should present to your health care provider when seeking care. With MA plans, you will have a membership card that you will present to your health care provider. This card is different from the red, white, and blue card that Original Medicare enrollees receive.
With Original Medicare plans, enrollees will be able to see any provider that participates in the Medicare program. With MA plans, enrollees will only be able to see in-network providers, but a referral may needed before an enrollee can see a specialist. However, MA preferred provider organizations (PPO) plans generally allow enrollees to see an in-network specialist without a referral.
Both Original Medicare and MA plans cover the same types of services and benefits provided under Medicare Part A and Part B; however, they may have different rules, costs, and restrictions.
Original Medicare plan enrollees are charged for standardized Part A and Part B costs, including monthly Part B premiums. Enrollees must pay a 20 percent coinsurance for Medicare-covered services if they see a participating provider and after meeting their deductible.
The cost-sharing in MA plans varies based on the type of plan selected. Enrollees are typically responsible for copayments for in-network care. Plans may also charge a monthly premium in addition to the Part B premium. If your health care costs are unaffordable, you may consider enrolling in a Medigap plan, which is detailed below in the Supplemental Insurance section.
Original Medicare plans do not have annual out-of- pocket limits. MA plans do. As a result, MA enrollees cannot be required to spend more than a specific amount of money out-of-pocket each year.
Original Medicare plans require enrollment in a separate prescription drug plan through Part D. MA plans incorporate prescription drug coverage into the standard benefit package; however, many plans charge a higher premium for this coverage.
Original Medicare provides coverage of services when you travel anywhere in the United States. MA typically only provides coverage of services offered within your plan’s service areas, except in emergencies.
If you have Original Medicare, you can sign up for a Medicare supplement policy, referred to as Medigap, to help cover some of the costs that Original Medicare will not cover. This includes copayments, coinsurance, and deductibles. Enrollees will be required to pay a separate premium for the Medigap policy. Medigap policies are guaranteed to be renewable.
Medicare Advantage enrollees are ineligible for Medigap policies.
MA plans may provide additional benefits, such as routine vision or dental services, routine hearing services, and membership in fitness programs. Original Medicare plans do not offer these additional benefits.
BE PREPARED FOR MEDICARE OPEN ENROLLMENT 2021 in Florida
Open enrollment for Medicare and Part D prescription coverage runs each year from Oct. 15 through Dec. 7. It’s a critical period for seniors, as this is when they can shop around for plans that will do a better job of meeting their needs next year.
Changes you can make include swapping from original Medicare (Part A hospital insurance and Part B medical coverage) to a private Medicare Advantage plan.
Medicare 2021 enrollment dates: The next open enrollment period will run from October 15, 2020 to December 7, 2020, for coverage effective in 2021.
Now that we’re getting closer to Medicare enrollment periods, information on the upcoming 2021 changes has recently been released.
The 3 biggest changes coming to Medicare Advantages plans are the expansion of telehealth services and coverage, coverage options for long-term care, and more coverage options for people with end-stage renal disease (ESRD).
To help the more than 22 million people enrolled in Medicare Advantage plans as of 2019 (that’s one-third of Medicare beneficiaries), we explain what seniors and family caregivers need to know about the 2021 changes.
Knowing about these upcoming changes helps you make the most informed decision when it’s time to re-enroll or choose a different plan.
1. Expanded telehealth services and coverage
Medicare Advantage plans will be seeing an increase in telehealth services and coverage to allow seniors to be treated by medical professionals while staying safe in their homes.
This is especially helpful for people who aren’t able to get to the doctor’s office easily or high-risk individuals who need to limit exposure to disease.
Telehealth allows seniors to video conference with their doctor from their homes, which provides both convenience and safety.
As part of the expansion of coverage to include telehealth services, Centers for Medicare & Medicaid Services (CMS) is giving Medicare Advantage plans the flexibility to include telehealth providers in certain practice areas including:
- Primary Care
2. Long-term care coverage through Medicare Advantage
Medicare Advantage plans provide the same coverage as Traditional Medicare, so they cover skilled services or rehabilitative care for up to 100 days. And they also include benefits for supplemental home care services for chronically ill beneficiaries.
Starting as early as this year, some Medicare Advantage plans will offer benefits for a variety of additional supplemental home care services.
While they still don’t provide coverage for assisted living expenses (and benefits vary by plan and location), these changes can make a huge difference in care by allowing more seniors to continue living independently.
Services we can expect to see added to some Medicare Advantage plans include:
Adult day care services
Adult day programs provide seniors with an engaging and social environment, as well as opportunities to receive memory care and additional exercise to improve well-being.
These programs also give caregivers a chance to take regular breaks.
In-home personal care services
Covering personal care services will allow seniors to receive assistance with daily activities such as getting dressed, eating, using the bathroom, etc.
The ability to have a home health aide help with these activities can delay the need to move to assisted living or a nursing home.
Benefits for over-the-counter products
Seniors on Medicare Advantage plans will begin to receive a monthly or quarterly allowance for over the counter products such as allergy and cold medications, daily supplements, and pain relievers.
Home safety modifications
If a beneficiary has fallen or has a hard time moving around but isn’t ready to make the transition into assisted living quite yet, some Medicare Advantage plans will provide coverage for safety modifications including grab bars for bathrooms, wheelchair ramps, and stair rails.
Meal delivery and transportation
With growing demand for transportation and meal delivery services, some Medicare Advantage plans will now cover transportation services (such as Lyft and Uber) to help seniors get to doctors’ appointments, fitness centers, or pick up prescriptions, as well as offer benefits for grocery delivery services.
3. More options for people with end-stage renal disease (ESRD)
Due to changes implemented by the 21st Century Cures Act, seniors with end-stage renal disease (ESRD) can now enroll in Medicare Advantage plans starting in January 2021 and have more coverage options with Medicare.
Previously, individuals with ESRD could only enroll in Medicare Advantage plans under limited circumstances.
Now, organ acquisition costs of kidney transplants will have coverage under the fee-for-service program instead of Medicare Advantage organizations.
However, there are pros and cons to these new changes that both beneficiaries and caregivers should be aware of.
For example, a positive in Medicare Advantage plans accepting ESRD patients is that the benefits offered to dialysis patients through Advantage plans include case-management services to assess their needs, set health goals, and provide ongoing support.
And, Medicare Advantage plans limit out-of-pocket costs to $6,700 per year. In contrast, seniors with ESRD who are enrolled in Medicare can face cost-sharing of up to $15,000 per year.
However, a negative is that areas with a high number of ESRD patients could face a reduction in health care benefits due to the complex and costly care associated with treating ESRD.
The issue is that if certain states have a significant amount of patients with ESRD, Medicare Advantage plans in those areas are likely to be underpaid and could be forced to raise consumer costs, reduce supplemental benefits, or limit services for all enrolled beneficiaries.
Additional changes and important dates
There’s a chance that additional Medicare changes will be announced in the coming months, so it’s important to keep an eye out for updates.
That keeps you informed and well-equipped to help your older adult choose the best plan for their needs when it’s time to re-enroll or change plans.
Also keep in mind that if you’re switching from Medicare to a Medicare Advantage, the Annual Enrollment Period is from 10/15/20 to 12/7/20.
If you’re changing to a different Medicare Advantage plan, the Medicare Advantage Open Enrollment period is from 1/1/21 to 3/31/21.
Medicare is essential to retirement planning. Working with your financial advisor can help you manage your premium costs.
Premiums for some parts of Medicare are based on your modified adjusted gross income from two years ago. MAGI also adds in capital gains, Social Security and required minimum distributions from individual retirement accounts and 401(k) plans.
That means premiums you’ll be paying in 2021 are going to be based on 2019’s income tax return.
There isn’t much you can do right now to modify your 2019 income. However, you still have time to plan for 2022’s premium expenses.
Talk to your advisor now to see what you can do to manage your income for this year. It can help you curtail Medicare costs in the future.
The Freedom to Choose Your Medicare Options in Florida
Most insurance company representatives only offer one plan, but we understand that your needs are unique, and can change. That’s why our agents are able to represent up to 18 Medicare Advantage and Medicare Supplement insurance plans from numerous carriers.
We provide you with several coverage options in your area, so you’re bound to find a plan that works for you.
It’s our goal to ensure you’re receiving the standard of health care you deserve.
Our agents are certified and trained with the top Medicare carriers.
Carriers known for delivering quality and valued service to all beneficiaries, no matter which plan you choose.
Ready to Compare Medicare Plans?
Regular reviews of your Medicare benefits are important. Your needs change. Medicare plans change. But navigating through the plan options and keeping up with the annual changes of benefits is probably about as appealing as calling into one of those automated systems that send you in seemingly infinite circles.
Fear not! We can match you with a highly trained Licensed Agent who’s well-versed in all things Medicare.
When one of our advisors compare Medicare plans with you, here’s what you can expect:
- A thorough assessment of what you need from your health insurance.
- An overview of the Medicare plan changes, especially the ones that affect you.
- A candid discussion on the pros and cons of Medicare plan options.
- Professional advice on a plan that will best suit your needs and your budget.
It’s that simple.
There are no costs associated with this free review, and no obligation. Our job is to match your needs with the best plan for you.
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