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Preparing For Medicare Open Enrollment: 2021 Medicare Costs

The Centers for Medicare & Medicaid Services (CMS) has finally released Medicare costs for 2021. Knowing these costs will help you decide whether to stick with Original Medicare or buy a Medicare Supplement Plan to help pay for your Part B premiums and costs. Medicare Open Enrollment is still going on, but not for long! It will be over December 7, so read on to find out how you can be better prepared for next year.

Medicare Part A Premiums/Deductibles

money bills spread out on a table with a stethoscope on top of it. — *Medicare Part A (hospital insurance) deductible has one up $76 dollars.*

Medicare Part A is hospital insurance, and covers things like skilled nursing facilities, inpatient hospital stays, and some home healthcare services. If you are 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years, then you will be eligible for premium-free Part A.

The Medicare Part A inpatient deductible that you must pay when admitted to the hospital will be $1,484 for each benefit period in 2021, which is an increase of $76 from $1,408 in 2020. The breakdown for 2021 is:

Days 1-60- $0 coinsurance for each benefit period
Days 61-90– $371 coinsurance per day of each benefit period
Days 91 and beyond- $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
Beyond lifetime reserve days- you pay all costs

Medicare Part B Premiums/Deductibles

Medicare Part B is medical insurance and covers such things as doctor visits, outpatient hospital services, durable medical equipment (DME), and certain home health services. The government had indicated that Medicare Part B premiums would not increase by more than 25% in 2021. CMS’ announcement has now given us the exact amount they will increase by: Medicare Part B premiums for 2021 will be $148.50, which is an increase of $3.90 from $144.60 in 2020. Your premium amount may be higher depending on your income:

CMS also announced that the annual deductible for Medicare Part B will be $203 in 2021, which is an increase of $5 from $198 in 2020. You will continue to pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment after this $203 deductible is met.

Considering A Medicare Supplement Plan

Although the costs are not going up by too much next year, for some who are on a fixed income or a tight budget, an almost $4 a month rise in premiums can be a lot. On top of that, the 20% coinsurance you will have to pay could increase with the rising costs of healthcare. Luckily there are ways to help pay for coinsurance and save money.

Medicare Supplement Plans are perfect for beneficiaries looking to save money and have more of their medical care covered. There are 10 different Medicare Supplement Plans to choose from, each with different price points and coverage options. If you are interested in looking into these plans but do not know where to start, allow an EZ.Insure agent to help. Our licensed agents work with the top-rated insurance companies in the country and can compare plans in your area in minutes. We will assign you one and only one agent who will go over your budget and medical needs. They will compare Medicare Supplement Plans to find the one that is best for your needs. What’s even better is that all of our services are free! To get instant free quotes, simply enter your zip code in the bar above, or to speak directly to an agent, call 888-753-7207.

Medicare When Self-Employed

For many people, turning 65 and starting to collect Social Security means being automatically enrolled into Medicare. There are exceptions to this and ways to put off enrolling into Medicare, such as if you are still working and have health insurance through your employer. But what happens when you are self-employed and you’re about to turn 65? Do you have to sign up for Medicare, or can you delay enrolling without facing a penalty? Being self-employed impacts your Medicare options, so it is important to understand how you can be fully insured and avoid any penalties.

How Medicare Works

the numbers 65 as candles that are lit — *Normally, if you are collecting Social Security, then you will be automatically enrolled into Medicare when you turn 65.*

Self-employed or not, as long as you have been paying income taxes in the U.S., you will be automatically enrolled in Medicare Part A when you turn 65, but only if you are already receiving Social Security. If you are not receiving Social Security, then you will need to manually sign up for Medicare during your Initial Enrollment Period, which is the 3 months before your 65th birthday, the month of your 65th birthday, and the 3 months after your 65th birthday. You can sign up for Medicare Parts A and B at this time or you can choose to opt out of Part B; it is optional because it has a premium. If you decide to enroll in Part B later, though, you will pay a penalty on your premium for as long as you have Medicare. If you do decide to enroll into Medicare and you are still self-employed, then Medicare will be your primary insurance.

Self-Employed With Marketplace Plan

If you are (or were) self-employed, you might have a Marketplace insurance plan if you aren’t covered by your spouse’s employer-based plan. When you turn 65, you have the option to cancel your Marketplace plan without a penalty and join Medicare, or you can choose to keep your Marketplace plan. If you do decide to keep your health insurance plan, then it will become secondary to Medicare, meaning Medicare will be your primary payer. Be aware that having a Marketplace plan does not qualify you to delay enrolling in Medicare without a penalty, so you will have to enroll in Medicare during your Medicare Initial Enrollment Period when you turn 65 in order to avoid paying extra on your Part B premiums.

Self-Employed With Employer-Based Coverage

older caucasian man working on a saw table — *If you are enrolled in an employer’s health plan, then you can wait to enroll into Medicare without penalty.*

If you don’t have a Marketplace plan, but are covered through another job you have or through your spouse’s plan, then you might be able to wait to enroll into Part B and not face a penalty. If you or your spouse’s workplace has fewer than 20 employees, you will be required to sign up for Medicare at age 65, but if it has fewer than 20 then you will not have to.

The number of employees at you or your spouse’s workplace also determines which insurance plan will be your primary payer. If you or your spouse’s workplace has 20 or more employees, the employer-based plan will be primary. If you sign up for Medicare and you also have an employer-based plan through a business with less than 20 employees, then your employer’s health plan will become secondary coverage after Medicare.

Self-Employment & Medicare Premium Deductions

Since 2012, the IRS has allowed self-employed individuals to deduct all Medicare premiums from their federal taxes. This includes Medicare Part B and Medicare Part A premiums, Medicare Supplement Plan premiums, and your spouse’s Medicare premiums. When deducting your Medicare premiums, your premium payments are subtracted from your gross income, which is different from doing an itemized deduction for medical expenses that are taken after your adjusted gross income (AGI) is calculated. In order to deduct your premiums, you have to report a profit from your business.

Using Your HSA

If you are 65 or older and self-employed, you can open and contribute to an HSA as long as you meet these HSA eligibility requirements:

You’re covered by a HSA-qualified medical plan.
You’re not someone’s tax dependent.
You don’t have any conflicting coverage (including being enrolled in Medicare).

If you are enrolled in Medicare then you can no longer contribute to your Health Savings Account (HSA). However, you can continue to withdraw money tax-free from the account and use it to help pay your Medicare premiums, deductibles, copays, and coinsurance.

Understanding how Medicare works can be tricky. You need to make sure that you have all of your bases covered so you are insured and do not receive any surprise bills. EZ.Insure will go over all of your options and make sure that you are prepared to transition to Medicare, and we can sign you up for a Medicare Supplement Plan for extra savings if need be. To get instant, free quotes, enter your zip code in the bar above, or to speak to one of our licensed agents, call 888-753-7207.

Beware Of Medicare Scams During Open Enrollment

Medicare Open Enrollment is the perfect opportunity for you to change plans and find ways to get more coverage and save money. Medicare Open Enrollment is also the perfect opportunity for scammers to try and steal your information. They know that you will be looking for the best coverage at this time, so they’ll jump on the chance to confuse, bait, or scare you. In order to protect yourself, you have to be aware of the most common scams and scamming tactics.

The Different Types of Scams

The most important thing you need to know is that, unless you request information from them, Medicare will not call you. You should treat any unsolicited calls from someone claiming to be with Medicare as suspicious; in fact, the majority of Medicare scams are phone calls. Here are scams to look out for:

A call or recorded message from someone who claims to be helping you navigate your Medicare options. This person might claim that they are an advocate working on your behalf, and that they can enroll you in a better, cheaper Medicare plan if you give them some personal information. If you did not sign up for help, then this is a scammer trying to get your information.
A call from someone claiming to be with Medicare who offers you promotional gifts.
A call from someone claiming to be with Medicare who threatens to discontinue your insurance if you don’t re-enroll now.
If you suspect a scammer has contacted you, call 1-800-Medicare to report it.

What To Do

No one representing Medicare will ever contact you by phone, email, or in person unless you have already made contact with them. The best way to avoid any scam is to never give your Medicare ID number, Social Security number, health plan information, bank information, or any other personal information to someone that you don’t know.

If you do receive a call that is suspicious, then hang up and call 1-800-Medicare to report it. Then contact your Medicare agent, or Medicare, to make sure that there is nothing wrong with your current plan, and that there are no actions that you need to take.

Getting Trusted Help

Medicare Open Enrollment can be a very busy and overwhelming time. You are in the midst of figuring out if your current plan is right for you, and researching other plans in your area to try to save money and get the most coverage. On top of that, you have to worry about people trying to steal your information. You can protect yourself from the many scammers out there by knowing their scare tactics and the ways that they will pretend to help you. In addition, you can make sure that you are fully protected from identity theft or worse by contacting an EZ agent!

EZ.Insure uses state-of-the-art technology to protect your information when you fill out our online form. To further protect your information, we will only share it with one agent. Whether you want to know more about your Medicare options, sign up for a Medicare Supplement Plan, or simply compare plans, EZ’s got you covered. With us, you will never have to worry about outside parties getting their hands on your information. To start comparing quotes for free, enter your zip code in the bar above, or to speak directly to an agent, call 888-753-7207.

B.E. F.A.S.T When You Spot A Stroke

Strokes are more common than you might think: they are one of the leading causes of death and disability in the US. According to the CDC, each year almost 800,000 people suffer a stroke. Nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after the age of 55. Strokes can have devastating and long-lasting impacts, but spotting a stroke quickly could mean reducing the damage done. The earlier you can get help, the better, so it is vital to know what to watch out for.

older caucasian man with one side of his face drooping — *Facial weakness or uneven smile is one of the symptoms of a stroke.*

Spotting The Signs Of A Stroke

Strokes happen suddenly when blood flow to the brain is disrupted or cut off. Once this happens, brain cells start dying; the more brain cells that die, the higher the risk of becoming paralyzed or dying. The classic warning signs of a stroke to look out for are simple – use the acronym B.E. F.A.S.T. to remember them:

B – Balance. Sudden dizziness, loss of balance or coordination.
E- Eyes. Sudden trouble seeing out of one or both eyes
F- Face. Facial weakness or uneven smile
A– Arm. Weakness or inability to raise both arms evenly
S– Speech. Impaired, slurred speech, and/or difficulty repeating back simple phrases
T– Time. Every second counts, so call 911 immediately

Additional Symptoms Of A Stroke

Strokes can also cause:

Sudden confusion, trouble speaking, or understanding others when they speak
Chest pain is also a sign of a stroke.
Hiccups
Sudden severe headache with no known cause
Chest pain
Feeling weak all over
Rapid heartbeat
Shortness of breath

What To Do If You Suspect a Stroke

A stroke victim needs treatment right away. If any of the common warning signs are present, use the F.A.S.T test to help determine whether someone is having a stroke:

F (Face) – Ask the person to smile, and if one side of their face droops or the smile is uneven, that’s a sign of weakness or numbness in the face, which could indicate a stroke.
A (Arms) – Ask the person to raise both arms, and if one arm drifts downwards, that’s a sign of weakness on one side of their body.
S (Speech) – Ask the person to repeat a simple phrase. Slurring, sounding strange, or being unable to repeat the phrase are tell-tale signs of a stroke.
T (Time) – If the person shows any of these symptoms, get help immediately by calling 911. Let the operator know what time the test was given so they can estimate when the stroke occurred.

Even if symptoms go away, that doesn’t mean that the person is in the clear; a mini-stroke can last up to 24 hours. Any sign of a stroke could mean lasting damage, because these symptoms indicate that brain cells have begun to die. It is better to be on the safe side, so even if symptoms seem to pass, go to the emergency room or call 911. A health professional can administer tests, and can help to get the condition under control in order to reduce the risk of a stroke in the future. Every minute counts!

Does Medicare Cover Allergy Testing?

Allergies. Anyone can suffer from them, no matter their age. They can be seasonal, they can be food-related, they can be triggered by pets…but no matter the cause, they’re always annoying, and sometimes dangerous. Over 50 million people in the United States live with allergies, making them the sixth leading cause of chronic illness. Allergies can develop at any stage in your life, so what happens when you suspect that you’ve developed an allergy to something when you’re 65 or older? Will Medicare cover the necessary testing?

Eligibility

back of a woman with her hair in a ponytail in a lab testing something — *The laboratory where the allergy testing is done must be Medicare approved.*

Medicare coverage eligibility is always determined by how necessary and reasonable the treatment is considered to be. Allergy tests are considered “clinical diagnostic laboratory services,” which means they will be covered under Part B as long as you meet certain criteria:

Your doctor must prescribe an allergy test
The doctor prescribing the allergy testing must be enrolled in Medicare and accept Medicare assignment.
The allergy testing must be done in laboratories that are Medicare-approved.
No previous kinds of therapy have been able to help manage your allergies
Your doctor can prove that the testing is the first step in a complete, Medicare-approved treatment program.

Not all allergy testing procedures are covered by Medicare, so it’s important to know which tests are covered. In order to find out which ones are, you need to contact your physician before testing to make sure that Medicare will pay for your specific procedure.

The Different Allergy Tests Covered By Medicare

purple glove holding a tube full of blood — *Allergy testing can be done by testing the blood for allergens.*

Medicare will begin covering any allergy testing after you meet your annual Part B deductible. Medicare will then pay for 80% of the cost of your diagnostic testing. The following types of allergy tests are usually covered:

Skin Procedures– this type of test looks for allergies related to substances such as food, pollen, certain drugs, and more. The skin is pricked or scratched, the suspected allergens are applied to the area, and then the reaction is recorded.
Blood Testing- this type of test looks for allergies by analyzing the antibodies in your blood after your body comes in contact with allergens.
Food Challenge- in this test, which is used to confirm or rule out allergic reactions to foods, you are required to eat increasing amounts of the suspected food allergen until you have a reaction, or until your doctor can rule it out as the cause of your symptoms.

Before undergoing any testing, make sure you notify your doctor of all the current medications you are taking, as some medications can interfere with the results of your tests.

When To Get Help

Some symptoms of an allergic reaction will happen immediately after being exposed to the allergen. Symptoms of the more serious reactions include swelling of the throat, which can lead to death if not dealt with immediately. If you experience any of the following symptoms, you should make an appointment with your doctor as soon as possible:

caucasian woman's chest with pink hives all over it — *One of the many signs of allergies are breaking out in hives that are red and itchy.*

Sneezing and itchy, runny nose
Blocked nasal passages
Itchy eyes that are red and watery
Hives that are red and itchy
Swollen lips, tongue, face, or eyes
Coughing
Skin that is dry, cracked, and irritated
Wheezing and shortness of breath
Swelling of the mouth or throat

Millions of Americans experience allergies – if you’re one of them, know that it is possible to manage your symptoms, as long as you are aware of the allergy, and take the necessary medications. If you experience any of the symptoms listed above, talk to your doctor about getting an allergy test. Make sure that the doctor is Medicare-approved and that any tests being performed are approved by Medicare, as well. Some allergies can be life-threatening, so if you suspect you have an allergy, get tested, because it might just save your life.

Preparing For Medicare Open Enrollment: Medicare’s 2021 Part B Premium Capped By Congress

Amid uncertainties about Medicare prices for 2021, Congress has taken action to provide some relief next year for the 64 million Medicare beneficiaries in the United States. On Wednesday, September 30th, a short-term government funding bill was passed by the Senate and signed by President Trump that will cap Medicare Part B premiums for 2021. There has been no official announcement indicating how much premiums will be next year, but thanks to the bill, any increase will be capped at 25% of what it otherwise would have been.

picture of congress building — *A short-term government funding bill was passed by the Senate will cap Medicare Part B premiums for 2021.*

No Real Numbers Yet

Medicare Part B premiums rose nearly 7% in 2020, which had Medicare trustees predicting back in April of this year that the standard 2021 Part B premium would be $153.20, a 6% increase. However, due to the pandemic, there has been uncertainty surrounding Medicare prices for next year. The impacts of COVID-19 might be a major factor in determining how much premiums will increase.

“One thing that’s really hard about this year is that there’s been increased costs from treating Covid, but decreased cost from people delaying care or avoiding being in hospitals or doctors offices,” said Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center.

Social Security COLA Role

social security card under some money bills and coins — *Social Security COLA is expected to be 1.3%, but this might not be enough.*

It is also unclear whether Social Security’s associated annual cost of living adjustment, or COLA, will be enough to cover next year’s increase in Medicare premiums. The COLA, which is provided to seniors to help with the costs of necessities like Medicare premiums, is estimated to increase 1.3% next year, meaning the average monthly benefits will increase from $1,053 to a little over $1,522.

A discrepancy between the increase in Part B premiums and the increase in the COLA wouldn’t necessarily be a major problem for Social Security recipients. If Part B premiums increase is more than the COLA, then Medicare beneficiaries who are collecting Social Security are “held harmless.” This means that they can see a premium increase but it can’t be larger than their COLA dollar-amount increase. Unfortunately, Medicare beneficiaries who are not collecting Social Security benefits absorb the extra costs, which means they could see a sharp rise in premiums.

“What seems to be motivating Congress is the fear that there will be an unexpected spike in premiums, or one that’s out of step with normal premium increases across the board, or specifically for those not held harmless,” Schwarz said.

The Cap

sign of a red hand in a red triangles — *Congress put a cap on Part B premiums so that it is guaranteed to not exceed a 25% rise.*

While we would normally have a good idea by now of how much premiums are going to be for the following year, the pandemic is putting everything on hold. Only 25% of Part B is funded through premiums; the other 75% is funded through money from the federal government’s general revenue – this year, the government took a “loss” by providing millions of Americans, hospitals and businesses with financial relief, and so that loss may be passed on to Medicare beneficiaries.

Even if Congress has capped the premiums and will not allow them to increase by more than 25% of what they would have increased by, that percentage could still mean a large jump in premium prices. Many Medicare beneficiaries could still end up struggling to keep up with costs. Premium prices are expected to be revealed in early November.

If you need help planning for next year, consider getting help from an EZ.Insure agent. Our licensed agents will help you prepare financially for next year, and review all Medicare options in your area. To get free advice and quotes on plans, enter your zip code in the bar above, or to speak directly to one of our agents, call 888-753-7207.

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