MEDICARE OPEN ENROLLMENT

What and when is the Medicare special enrollment period?

Medicare open enrollment started on 15 October and those eligible will have until 7 December to select a Medicare Advantage or Part D prescription drug plan

0
What and when is the Medicare special enrollment period?
AFP CHRISTOPHE ARCHAMBAULT

Each year those eligible for Medicare have several weeks to enroll and update their plan selection. The open enrollment period began on Friday, 15 October, and will come to a close on 7 December.

When one reaches the age of sixty-five and claims their Social Security benefits, they are enrolled in Medicare Part A and B. During open enrollment, seniors have the choice to select a Medicare Advantage Plan or Part D, prescription drug plan.

What are the various 'Parts' of Medicare?

There are three major “Parts” of Medicare:

  • Part A: which covers hospital stays, skilled nursing, and hospice services;
  • Part B: which covers outpatient services, most doctors visits, and most drugs that need to be administered by medical professionals; and
  • Part D: which covers most “self-administered” prescriptions.

Some seniors elect to add additional coverage for things like vision and dental through a Part C or Medicare Advantage plan.

How much were the Medicare Part A and B premiums in 2021?

The Center for Medicare and Medicaid Services (CMS) has yet to announce the premiums for Part A and B for 2022.

Part A

The majority of those who receive Medicare benefits do not pay a premium for Part A. There are three main reasons why some are eligible to receive premium-free benefits; 

  • You receive retirement benefits from Social Security or the Railroad Retirement Board.
  • You are "eligible to get Social Security or Railroad benefits but haven't filed for them yet."
  • You or your spouse has Medicare-covered government employment.

In 2021,  those who did not fall into these categories can buy Part A coverage for

  • $471-- paid Medicare taxes for less than thirty quarters
  • $259 -- paid Medicare taxes for between thirty and thirty-nine quarters. 

Part B

Medicare Part B Premiums

File individual tax return File joint tax return File married & separate tax return Monthly Total
$88,000 or less $176,000 or less $88,000 or less $148.50
$88,000 to $111,000 $176,000 to $222,000 N/A $207.90
$111,000 to $138,000 $222,000 to $276,000 N/A $297.00
$138,000 to $165,000 $276,000 to $330,000 N/A $386.10
$165,000 to $500,000 $330,000 to $750,000 $88,000 and less than $412,000 $475,20
$500,000 and up $750,000 and up $412,000 and above $504.90

Source: Medicare.gov

This year, the vast majority of Medicare members paid $148.50 for Part B coverage.

However, the amount owed depends on your annual income. Each month the Social Security Administration will subtract any premiums for Part A and B from your benefit amount.

Changes to Medicare Part C and D in 2022

While the CMS has yet to announce the 2022 premiums for Parts A and B, they have released information on the changes members can expect to see with Parts C and D.

Part C -- Medicare Advantage Plans

Currently around a third of Medicare members are enrolled in a Part C Medicare Advantage Plan.

The CMS has announced that they will expand the availability of Medicare Advantage Plans for those with a chronic illnesses. Starting in 2022, the percentage of plans available to those with a chronic condition will increase from nineteen to twenty-five percent. The average monthly premium in 2022 for Medicare Advantage will decrease from $21.22 to $19 per month.

Part D

The CMS has announced that they will continue moving forward with a new model that aims to lower the cost of insulin for Medicare members.

This year, the Part D Senior Savings Model  will add two additional pharmaceutical suppliers and the CMS has announced that this will supply will ensure members have access to "a thirty-day supply of a broad set of plan-formulary insulins costs no more than $35."

Overall, however, premiums for Part D plans are expected to increase to $33 compared to $31.74 in 2021.