When is Medicare Open Enrollment 2021 and What's New!



2020 Medicare Open Enrollment Dates For 2021 Plan Year

  • The annual (AEP) enrollment period for Medicare is from October 15th to December 7th.

  • Changing Medicare Advantage Coverage is allowed after annual enrollment from January -March.

  • Coverage elected during the annual enrollment period is effective January 1, 2021.

What can you do during the annual enrollment period?

  • You can change from Medicare Advantage back to Original Medicare, or vice versa.

  • You can change from one Medicare Advantage plan to another

  • You can change from one Prescription Drug Plan (PDP) to another

If I want to keep the same plan will it Auto-Renew?

If you don't want to make changes to your coverage for the upcoming year, you don't have to do anything during open enrollment. That is assuming that your current plan is being continued. Keep in mind that benefits and premiums could change from one year to the next, so be sure to understand those changes and how they may apply.


What's New for 2021 Medicare Plans So Far?

  • Cures Act. The Cures Act amended the Social Security Act (the Act) to allow all Medicare-eligible individuals with End Stage Renal Disease (ESRD) to enroll in Medicare Advantage (MA) plans beginning January 1, 2021. CMS codified this statutory change in regulation. This final rule takes an important step in improving the lives of beneficiaries with ESRD, which is a priority in alignment with the Executive Order on Advancing American Kidney Health.

  • Medicare Part B likely to increase in cost for 2021. Based on reporting from the Centers for Medicare & Medicaid Services (CMS), the projected 2021 Medicare Part B premium is $148.50 per month.* It’s important to note that this figure only represents an estimate of 2021 Part B premiums. Actual 2021 premiums will be determined in the fall of 2020. The standard Part B premium in 2020 is $144.60 per month. That’s an increase of $9.10 from the 2019 Part B premium. * Medicare: Part B Premiums. (Updated April 4, 2019). EveryCRSReport.com. Retrieved from www.everycrsreport.com/reports/R40082.html.

  • Medicare Part D Deductible increasing about 2.3%. The 2021 standard Initial Deductible will increase $10 to $445 from the current 2020 standard Initial Deductible of $435.  What this means to you:  The Initial Deductible is the amount that you must pay before your Medicare Part D plan begins to share in the cost of coverage.  If you enroll in a Medicare Part D prescription drug plan with a standard Initial Deductible, you will spend slightly more out-of-pocket in 2021 before your plan coverage begins. As a note, the majority of 2020 Medicare Part D plans have an initial deductible.  But, as we see in 2020, many popular Medicare Part D plans exclude lower-costing Tier 1 and Tier 2 drugs from the deductible, providing plan Members with immediate coverage for some lower-costing medications. The Initial Deductible and the Donut Hole: The Initial Deductible will not affect when you enter the Donut Hole or Coverage Gap, but will impact when you leave the Donut Hole and enter the Catastrophic Coverage portion of your Medicare Part D plan coverage.  In other words, what you spend toward your Initial Deductible is counted toward your total out-of-pocket spending threshold or TrOOP.

  • The Initial Coverage Limit is proposed to increase $110 to $4,130 from the current 2020 of $4,020. The Initial Coverage Limit marks the point where you enter the Donut Hole or Coverage Gap.  Medicare Part D beneficiaries enter the Donut Hole when the total negotiated retail value of their prescription drug purchases exceeds their plan’s Initial Coverage Limit. What this means to you:  You will be able to buy slightly more medications before reaching the 2021 Donut Hole or Coverage Gap (assuming that the retail price of your medications does not increase over time).

  • Total Out-of-Pocket Limit will increase by $200 to $6,550 from the current 2020 TrOOP limit of $6,350.  TrOOP is the actual dollar figure you must spend (or someone else spends on your behalf) to get out of the Donut Hole or Coverage Gap and into the Catastrophic Coverage phase of your Medicare Part D plan and TrOOP does not include monthly premiums or non-formulary purchases


Next Steps?


Each year Medicare beneficiaries should review their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their current plan provider. These notices should be received by September 30, 2020. Look for changing co-pays, changes to the prescription drug formulary and/or changes to the treatment of coverage.

Need Additional Help?

Contact AJM Associates at (248) 778-6070 or via email at kruth@ajmassoc.com

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