Being new to Medicare can be extremely intimidating. Not knowing if, when, and how to apply is confusing enough. Then, you can top the confusion off with all the annual Medicare changes.
Even if you’re already enrolled, there can oftentimes be uncertainty about what is and is not covered, especially during this global pandemic. We’ll start off the article by highlighting the changes that have been made to Medicare in light of COVID-19 and will then get into what to know if you’ll be enrolling this year.
COVID-19 and Medicare
Medicare has acted swiftly to ensure all beneficiaries have the coverage they need if they become ill with the coronavirus. First and foremost, CMS announced that Medicare will be covering testing for COVID-19 (after February 4, 2020) under Medicare Part B. Those with Medicare Advantage will also be covered for testing, as Advantage plans are required to cover all services covered by both Part A and Part B. In addition, all cost-sharing associated with testing has been eliminated.
In regards of where to get tested, your doctor will likely be able to get you a test, or there are drive-through testing sites popping up throughout the U.S. where those 65 years and older are considered a priority. (You should contact your state health department for information on testing sites.)
If treatment becomes necessary, any treatment administered in an inpatient setting will fall under Part A, so those admitted to the hospital will be responsible for the Part A deductible, as well as any copays for extended stays. Those with a Medigap plan will have coverage for the Part A deductible and any copays accrued for up to 365 days.
Any treatment administered in an outpatient setting will fall under Part B, where beneficiaries will be responsible for the Part B deductible and the 20% coinsurance. Those with a Medigap plan will have coverage for the 20% coinsurance, and depending on the specific plan, may have coverage for the deductible as well.
For beneficiaries with Medicare Advantage, cost-sharing will depend on the carrier you’re enrolled with as they determine what you pay in copays and coinsurance.
Additional measures taken by Medicare for healthcare related to COVID-19 include issuing Section 1135 Waiver to provide flexibility in coverage so all beneficiaries can access health care during this pandemic, and waiving both out of network coverage restrictions and telehealth services restrictions. For more information, please check out this page which is updated as CMS releases information and resources.
Applying for Medicare as a New Beneficiary in 2020
Due to technology, applying for Medicare is quite easy. If you’re collecting Social Security or Railroad Retirement Benefits, you’ll automatically be enrolled in Part A & Part B. Coverage will begin the first day of the month you turn 65.
If you’re not collecting retirement benefits yet, you can enroll yourself in Medicare on ssa.gov. If you plan to continue working past 65 and have employer group coverage, it’s essential to know if your benefits are considered creditable coverage under Medicare.
If you delay Part B & Part D without creditable coverage, you’ll risk being penalized for not enrolling when you were first eligible. As long as you have coverage that’s considered creditable, you’ll qualify for a Special Enrollment Period when you do apply for Medicare at a later time.
Most new beneficiaries still choose to enroll in Part A when they’re first eligible, even if they have group coverage, since it’s usually premium free.
Medicare Changes in 2020
Many changes happen with Medicare annually. Here are the most important ones to note.
Due to MACRA, beneficiaries are now divided into two separate eligibility buckets.
- non-newly eligible
- newly eligible
Those considered non-newly eligible qualify to enroll in any first-dollar coverage plan. Those considered newly eligible will not qualify for any plan considered first-dollar coverage.
For non-newly eligible:
First-Dollar Coverage Plans: for non-newly eligible only
First-dollar coverage plans include Plan C, Plan F, and high-deductible Plan F.
First-dollar coverage means aside from the monthly premium; you’ll have zero out of pocket costs: no copays, no coinsurance, no deductibles (unless it’s a high-deductible plan).
Non-Newly Eligible Plan Options
Those who were eligible for Medicare before 2020 are eligible to enroll in Plan A, Plan B, Plan C, Plan D, Plan F, high deductible Plan F, Plan G, high deductible Plan G, Plan K, Plan L, Plan M, & Plan N.
For Newly Eligible:
Newly Eligible Plan Options
Those who first became eligible for Medicare after 2020 are eligible to enroll in Plan A, Plan B, Plan D, Plan G, high deductible Plan G, Plan K, Plan L, Plan M, & Plan N.
Runner Up Medigap Plan – Plan G
For those who are considered newly eligible, the plan with the most benefits that you qualify to enroll in is Medicare Supplement Plan G & high deductible Plan G.
Medicare Increases in 2020
- Part A premium increased to $458
- Part A deductible increased to $1,408
- Part B premium increased to $144.60
- Part B deductible increased to $198
Most beneficiaries are eligible for Part A premium free. Depending on the Medigap plan you choose, both Part A & B deductibles could be covered.
Lindsay Engle is a Medicare expert at MedicareFAQ. She loves sharing her expertise and knowledge with those who are looking to learn more about Medicare. Her goal is to make sure Medicare beneficiaries are given the right resources to become educated on all their Medicare options.