Medicare 101 for 2021 – What Seniors Need to Know

Medicare changes are just around the corner – January 1, 2021 to be exact – and it’s time to adjust your current coverage to make sure it meets all of your needs. Seniors and family caregivers especially need to be prepared for these updates and made aware of what changes will come into effect in the coming year in order to make an informed decision when it is time to enroll or change plans. Medicare open enrollment runs from October 15 through December 7 each year.

The best way to prepare is simply by reevaluating your current coverage, learning about the changes occurring in 2021, and making sure you are insured and protected for the coming year. It’s also important to understand the difference between Original Medicare versus Medicare Advantage, and which plan is better suited for you in terms of coverage and cost. One thing is certain – now is the time to get started.

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Medicare Open Enrollment for 2021

Medicare Advantage open enrollments begin on October 15 and goes through December 7 each year. Changes within Medicare Advantage plans start on January 1, 2021 and goes through March 31, 2021.

The 3 biggest changes coming to 2021 Medicare plans are the expansion of telehealth services and coverage, coverage options for long-term care, and coverage options for people with end-stage renal disease (ESRD).

Here are the top changes you need to be aware of:

Telehealth Services and Coverage

2020 has opened our eyes to the possibilities that exist right in the comfort of our own homes, including meeting with your doctor. You will now be able to schedule an appointment to discuss health concerns without having to leave your house. With seniors being high-risk individuals who are most prone to disease, this Medicare service is an especially helpful update.

Teleheath – also known as telemedicine – allows individuals to video conference with their doctor and health care providers from their own homes. Everyone, especially seniors and care givers, can enjoy the comfort and convenience of staying home in a safe environment. Seniors will be able to take advantage of virtual services and check-ins through the new Medicare and Medicare Advantage innovative service.

Medicare Advantage plans will offer increased coverage for various services including:
– Primary care
– Cardiology
– Dermatology
– Psychiatry
– Gynecology
– Endocrinology

Note: Some plans may offer different coverage than others. Search online to find out which plans will suit you.

Long-term Care Coverage through Medicare Advantage

Medicare Advantage and traditional Medicare plans cover skilled services or rehabilitative care for up to 100 days, however, an update coming in 2021 will allow for long-term care coverage and will offer benefits for additional supplemental home care services. These changes will make a significant difference for aging adults as they will allow more seniors to continue living independently and delay the need to move to assisted living while still providing help for their daily care needs.

Services that will be added to some Medicare Advantage plans include:

– Adult day care services
o Seniors can engage in social activities including mental stimulation games and light physical activity for overall well-being
– In-home personal care services
o Assistance in daily activities such as getting dressed and eating
– Benefits for over-the-counter products
o Enrollees will receive periodic allowance for over-the-counter products as an added benefit to their Medicare Advantage
– Home safety modifications
o Some plans can provide coverage for home modifications including wheelchair ramps, stair rails, and more
– Meal delivery and transportation
o Some plans will cover transportation services to help seniors get to where they need to be as well as benefits for grocery delivery to their homes

Note: Coverage options vary on the plan you are currently enrolled in or the plan you choose to enroll in.

Expanded Options for Seniors with End-Stage Renal Disease (ESRD)

Seniors with end-stage renal disease (ESRD), also known as kidney failure, were only able to enroll in certain Medicare Advantage plans under limited circumstances. Due to Congressional action, starting in 2021, seniors with end-stage renal disease (ESRD) will have the option to enroll in Medicare Advantage.

One of the biggest benefits of this change will be how much you spend out-of-pocket with Medicare Advantage versus Original Medicare. Medicare Advantage plans have an annual out-of-pocket spending cap of $6,700, which is less than half of Original Medicare’s annual cap of $15,000.

Other benefits will include services to assess personal needs and provide ongoing support.

Learn More About Medicare Advantage

Medicare Advantage offers many benefits, including convenient coverage, various plan options, and long-term savings. In 2021, Medicare Advantage will have significant updates that can be better suited for many individuals, especially seniors and care givers.

Before you make a decision, take the time to research online and weigh your options. More changes could be announced in the next few months, and it is important that you are well-informed before making a decision.

Keep in mind all enrollment dates and deadlines that apply to you or your older adult to be sure you obtain the best possible plan.

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