Medicare Advantage Enrollees Can Still Make a Change, Possible Special Enrollment Periods, Medicare Cost-Sharing Rates for 2021
1. Medicare Advantage Open Enrollment Period (MA-OEP)
People who began 2021 enrolled in a private Medicare Advantage (MA) plan have an additional opportunity to switch MA plans or dis-enroll from an MA plan and return to traditional Medicare with a Part D plan during the first 3 months of the calendar year. This enrollment opportunity, called the Medicare Advantage Open Enrollment Period (MA-OEP), is not available to individuals who are in traditional Medicare and enrolled in a stand-alone Part D plan.
2. Special Enrollment Period (SEP)
In addition, there are certain rights to use a Special Enrollment Period (SEP) to change or get out of a plan in certain circumstances. There are a number of SEPs, including when someone receives inaccurate or misleading information from the Medicare Plan Finder, customer service representatives at 1-800-MEDICARE, or an MA or Part D plan (or its agents). For a full list of available SEPs, see, e.g., for MA SEPs: Medicare Managed Care Manual, Chapter 2 (2021 update available here) and Title 42, Code of Federal Regulations §422.62(b); for Part D SEPs see Medicare Prescription Drug Manual, Chapter 3 (2021 update available here) and Title 42, Code of Federal Regulations §423.38.
3. Medicare Cost-Sharing for 2021
Part A Monthly Premium (For those not automatically enrolled)
- 0-29 qualifying quarters of employment: $471
- 30-39 quarters: $259
Inpatient Hospital
- Deductible, Per Spell of Illness: $1,484
- Co-pay, Days 1 – 60: $0
- Co-pay, Days 61 – 90: $371/day
- Co-pay, Lifetime Reserve Days: $742/day
Skilled Nursing Facility
- Co-pay, Days 1 – 20: $0
- Co-pay, Days 21 – 100: $185.50
Standard Monthly Part B Premium
- $148.50
Part B Deductible
- $203
For the Parts B & D Income-Related Premium Amounts, see https://medicareadvocacy.org/medicare-cost-sharing-announced-for-2021/