One of life’s most important milestones is signing up for Medicare health insurance. Every year in the United States, around one million new beneficiaries begin their Medicare coverage. Today, there are just under 64 million Medicare recipients, accounting for about 18 percent of the population in this country.
Whether you’re new to Medicare this year, or you’re doing your research for your upcoming enrollment, you need to know some of the basics of your coverage. It’s also important to keep up with the annual changes that Medicare may implement.
Medicare basics for those new to the program
People become eligible for Medicare insurance when they turn 65, or if they have a qualifying disability and meet the requirements. If you are receiving Social Security or Railroad Retirement Board benefits when you turn 65, the Social Security Administration automatically enrolls you in Medicare. If you aren’t receiving benefits when you turn 65, you can enroll yourself in Medicare, or you can wait until later if you have comparable group insurance through an employer. If you delay enrollment in Medicare Part B or Part D and do not have other creditable coverage, you may be subject to late enrollment penalties when you sign up later on.
When you are eligible for Medicare you can:
- Enroll in Original Medicare Part A and/or Part B or a Medicare Advantage (Part C) plan as alternative coverage. Medicare Advantage (MA) plans are required to include the same Part A and Part B benefits as Original Medicare, but most plans include additional benefits, such as vision care, dental care, hearing exams, prescription drug coverage, or more.
- Enroll in Medicare Part D which is prescription drug coverage. You can enroll in a stand-alone Prescription Drug Plan (PDP) if you have Original Medicare or a Medicare Advantage plan that includes prescription drug coverage.
- Purchase a Medicare Supplement (Medigap) plan if you’re 65 and enrolled in Original Medicare Parts A and B. You’ll have a Medigap initial enrollment period that will last 6 months when you turn 65 and enroll in Part B. and allow you to purchase any Medigap plan sold in your state without being subjected to medical underwriting. If you wait until your initial enrollment period ends, you could be charged more or refused coverage based on pre-existing conditions.
Important dates to remember:
- October 15th to December 7th is Medicare’s Open Enrollment Period when Medicare beneficiaries can change health care and/or prescription drug coverage. You can join, switch, or drop a Medicare Advantage plan or a Prescription Drug Plan (PDP) during this time. You can also switch from Original Medicare to enroll in an MA plan, or drop your MA plan and revert back to Original Medicare (and enroll in a PDP at this time).
- January 1st is when your new coverage begins if you made a change during the Open Enrollment Period. But even if you keep your existing coverage, any changes to costs and coverage kick in on the first of the year.
- January 1st to March 31st is the Medicare Advantage Open Enrollment Period. If you have a Part C plan, you can change to a different one or switch back to Original Medicare and join a stand-alone Medicare Part D plan during this period. However, you can only switch once during this period. Changes you make take effect on the first of the month after the plan receives your application.
Staying on top of your Medicare health care and prescription drug coverage is vital to ensure that your health care needs and financial situation are satisfied.
New for Medicare in 2022
Here’s a look at some new costs for Medicare in 2022:
Cost changes for Medicare Part A
- The Part A deductible (per benefit period) increased from $1,484.00 in 2021 to $1,556.00 in 2022.
- Part A coinsurance costs for inpatient care on days 61 to 90 increased to $389.00 per day in 2022. It was $371.00 per day in 2021. For lifetime reserve days the charge is $778.00 per day in 2022, up from $742.00 in 2021.
- Part A premiums for those who don’t qualify for premium-free Part A: For those who have 31-39 quarter credits – $274.00 per month in 2022. For those who have less than 30 quarter credits – $499.00 per month.
Cost changes for Medicare Part B
- The standard monthly premium for Medicare Part B is $170.00 in 2022. It was $148.50 in 2021.
- The Part B annual deductible is $233.00 in 2022, up from $203.00 in 2021.
- Part B income brackets for high-income premium adjustments in 2022 begin at $91,000.00 for single people.
Some new coverage changes for 2022
Cognitive assessment and care plan services are now included in a second, separate visit to your health care provider as part of your annual Wellness visit. The services included in this benefit are covered by Medicare Part B which pays 80 percent of the final approved cost. You are responsible for the remaining 20 percent.
Blood-based biomarker exams are now covered by Medicare in some cases once every three years. To be eligible for this benefit you must be between 50 and 85 years old, have no symptoms of colorectal disease, and have an average risk of developing colorectal cancer. This exam is considered preventive, so Medicare covers 100 percent of the cost when it is done by a provider who accepts Medicare assignment.
COVID-19 coverage in 2022 includes all doses and boosters of vaccines, diagnostic testing, antibody tests, and monoclonal antibody treatment. As of 2022, Medicare covers 100 percent of the cost for all these services.
Turning 65? Explore your options
If you are eligible for Medicare for the first time in 2022, explore your options. If you’re turning 65 and enrolling in Medicare for the first time, you will have a 7 month enrollment period that begins three months before your 65th birthday, continues during your birth month, and ends three months after your 65th birthday month.
Compare the plans available in your area. Medicare Advantage plans and Prescription Drug Plans, although regulated by the federal government, are offered by private companies, so costs and benefits can vary. Online plan comparison tools are very helpful in narrowing down your options, but if you have further questions, speak to a licensed sale agent who can help you find the coverage you need at a price you can afford.