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You may be eligible for a government subsidy if your household income is under:
The Affordable Care Act (ACA) offers subsidies based on your household income, family size, and Qualifying Life Events.

You may qualify if...
One of the life events below has happened to you in the past 60 days:
  • I got married or divorced
  • I had a baby
  • A member of my family died
  • I moved to another state
  • i lost my job
  • I started a new job
  • I lost my health insurance coverage
and
Your income is under:
  • $45,960 - Individuals
  • $62,040 - Family of 2
  • $78,120 - Family of 3
  • $94,200 - Family of 4

Medicare open enrollment for 2020

Open enrollment allows you to review your plan and other options to see which Medicare plan works for you. 

Medicare open enrollment runs from Oct. 15 to Dec. 7 each year. Changes made during open enrollment begin on Jan. 1 of the following year.

Medicare's open enrollment is different than for the Affordable Care Act marketplaces, which are also called the exchanges. Open enrollment for those plans usually start on Nov. 1, but it can differ by state. 

Some seniors mistakenly think they can enroll in a Medicare plan through ACA health insurance marketplaces. But while the marketplaces will sell private individual health plans to people under age 65, they don't sell Medicare plans. People with Medicare do not need to enroll in the health insurance marketplaces.

Now, let's walk through what's new this year for Medicare, Medicare open enrollment options and what you need to know. 

What’s new in Medicare in 2020

The federal government has made a handful of changes in Medicare for 2020. 

Medigap changes

Medicare is getting rid of two types of Medigap plan options. Medigap, which helps people pay for Original Medicare (Parts A and B) out-of-pocket costs, isn’t available to people with Medicare Advantage. 

Medicare is ending new enrollment of Medicare Supplement Plans C and F. Why is Medicare stopping new enrollment to those plans? They have no deductible. Congress believes people with these plans are more apt to overuse health care services. The change means that all Medigap options will have a deductible option. So, members will have to pay some out-of-pocket costs when they use Medigap coverage. 

No one will be to sign up for Part C or F after Jan. 1, 2020. However, people already with those plans will be able to keep them. 

Though Medicare is ending enrollment for those two plans, it's also introducing a new high-deductible Medigap plan called Plan G. 

Find out more about Medigap plans

 

Original Medicare premium increases

People with Original Medicare can expect to see Part B premiums and deductibles increase.

  • Part B monthly premium will increase by $8.80 to $144.30.
  • The deductible will increase from $185 to $197. 

CMS is also increasing the income brackets for high-income people. That bracket will increase from $85,000 to $87,000 for a single person.

 

Medicare Advantage changes in 2020

People in Medicare Advantage, also called Part C, will more choices and lower premiums in 2020. Kaiser Family Foundation said there will be 3,148 Medicare Advantage plans available in 2020. That's an increase of more than 400 plans in 2019. 

Metropolitan areas will have an average 31 plans; non-metropolitan areas will average 16 plans in 2020. Seventy-seven counties have no Medicare Advantage option, which accounts for less than 1% of Medicare beneficiaries, Kaiser Family Foundation said. 

Americans will also see lower costs. The Centers for Medicare and Medicaid Services estimates that:

  • The average monthly Medicare Advantage premium will decrease by 14% to $23 in 2020. That’s a drop from $26.87. The average premium has declined by nearly 28% since 2017. The $23 premium is the lowest cost since 2007. 

Private insurers offer plans in Medicare Advantage, which makes up about one-third of Medicare eligibles. Medicare Advantage usually has deductibles associated with them. So, even though Original Medicare often has higher premiums, Medicare Advantage has higher deductibles.

One reason why there are lower premiums is that Medicare Advantage is a competitive market. CMS said there will be about 1,200 more Medicare Advantage plans in 2020 compared to 2018. The average number of Medicare Advantage plans available by county is 39 in 2020. That’s an increase of 33 in 2019. 

Also, more plans will have cost-sharing and additional benefits for people with conditions like diabetes and congestive heart failure. About 300 plans will offer those extra benefits in 2020. Medicare Advantage also offers plans with supplemental benefits for chronically ill beneficiaries that goes beyond a doctor’s appointment. These benefits include transportation to non-medical needs, meals and an enhanced living environment. These additional benefits are meant to help people’s overall health. About 250 Medicare Advantage plans will offer these benefits. 

CMS is additionally allowing Medicare beneficiaries to get new supplemental benefits. About 500 plans will provide expanded additional benefits, including adult care services and caregiver support services. 

Kaiser Family Foundation said that 97% of Medicare Advantage beneficiaries will have access to dental, fitness, vision and hearing benefits. Also, more than 90% of Medicare Advantage members will have access to plans with transportation assistance and meal benefits. 

About half will get to sign up for a plan with in-home support and bathroom safety supplemental benefits. Twelve percent will have access to caregiver support. 

Telehealth is a growing trend and in 2020, Medicare Advantage will provide more access to health services. Nearly one-third of beneficiaries will have access to plans with telehealth benefits, Kaiser Family Foundation said. 

You'll also have an easier time choosing plans in 2020. CMS launched a redesigned Medicare Plan Finder. The tool lets you compare original Medicare, Medicare Advantage and Part D prescription drug plans. Medicare enrollees can choose between Medicare and Medicare Advantage. They can also see about pairing a Part D plan with original Medicare. Part D is not available to people with Medicare Advantage since Part C plans often have prescription drug coverage. With that tool, you can also explore your options for Medigap.

Medicare open enrollment options

So, we've gone over what's new in 2020. Now, let's discuss open enrollment, which runs from Oct. 15 to Dec. 7.

During the Medicare open enrollment period you can:

  • Do nothing and keep your current Medicare medical and drug coverage.
  • Switch to a Medicare Advantage plan from Original Medicare.
  • Switch to Original Medicare from a Medicare Advantage plan.
  • Change Medicare Advantage plans.
  • Change Part D prescription drug plans, sign up for a drug plan if you don't have one now or drop drug coverage.

If you're turning 65

You have three months before your birth month and three months after your birth month to enroll in Medicare. 

If you have an ACA marketplace, workplace or individual health insurance policy, you can keep it until your Medicare coverage begins.  Once your Medicare starts, you can cancel your marketplace or private health insurance policy without penalty.  If you're continuing to work and receive group health insurance from your employer, you may be able to delay signing up for Medicare Part B (without penalties) until your employment terminates.

Part A, which covers inpatient care, is usually premium-free. So, you may want to enroll in Part A and keep your other coverage that covers outpatient and physician office visit care. 

Discuss with your employer your healthcare coverage, if this situation applies.

Review your annual Medicare changes

You may go through life changes that require you to change plans. For instance, your doctor may prescribe multiple medications or you may have a health scare. Plus, insurance companies add Medicare Advantage plans each year. It's a good idea to review your coverage annually and see if your plan is meeting your healthcare needs. 

You should receive an "Annual Notice of Change" from your plans before open enrollment begins. Review the information to understand Medicare coverage and costs for next year. Among the questions to ask:

  • Does the prescription drug plan cover the medications you take? What are the coverage rules for drugs? Can you use your pharmacy or get mail-order prescriptions?
  • Are your doctors and hospital in the health plan's network? Do you need to get referrals to see specialists?
  • How much will you pay in premiums and out-of-pocket health care costs, such as deductibles, copayments and coinsurance?
  • What is the plan's quality rating?
  • Will you have coverage when you're out of state or the country?
  • Do you have access to other coverage, such as group health through a current or former employer? How will Medicare work with that insurance?

 

Two main ways to buy Medicare plans

Original Medicare

The federal government runs Original Medicare, which includes Part A and Part B. Part A covers hospital care; Part B covers doctor visits, outpatient care, lab work, X-rays and preventive services.Medicare

You likely won't pay a premium for Part A coverage if you and your spouse paid Medicare taxes while working. You do have to pay a deductible, however, before hospital coverage kicks in. You pay a monthly premium for Part B, as well as a deductible and coinsurance.

With Original Medicare, you can see any doctor or go to any hospital that accepts Medicare.

You can add a prescription drug plan -- Part D -- to your Parts A and B plans. In Part D, private insurers sell drug plans, which are approved by Medicare. You pay a monthly premium for a drug plan. Part D plans aren't available in Medicare Advantage, but many of those plans have their own prescription drug plans. 

In addition ,you can buy a supplemental plan, called Medigap, to help cover some of your out-of-pocket costs. Private companies sell Medigap plans, which are standardized by letters A through N in most states.

You don't have a guaranteed right to buy or switch Medigap plans during the annual Medicare open enrollment period in the fall. The best time to buy a Medigap plan is during the first six months you're at least 65 and enrolled in Plan B.

During this period, federal law gives you the right to buy a plan, regardless of your health condition. You can still buy or switch Medigap plans later, but except in limited situations, Medigap plans can turn you down or charge you higher premiums based on your health. The Affordable Care Act provision prohibiting insurers from rejecting or charging higher premiums for people with health conditions doesn't apply to Medigap because the stipulation is only for those under age 65. 

Medigap plans are not insurance. They help you pay for healthcare costs. 

 

Medicare Advantage

Private companies approved by Medicare sell Medicare Advantage Plans. These plans usually operate like health maintenance organizations or preferred provider organizations.

You must use doctors or hospitals in the plan's network, or you pay more out of pocket for care. Medicare Advantage plans are an alternative to Original Medicare. Most cover prescription drugs. Some plans also cover vision and dental care. You pay a monthly premium as well as copayments or coinsurance. 

You cannot buy a Medigap plan if you have Medicare Advantage.

Medicare prices

Medicare Advantage premiums have dropped since the Affordable Care Act in 2010. 

How much does each type of Medicare cost? Here's a run down: 

Part A - Nearly all Medicare beneficiaries don't pay a monthly premium for Part A.  However, if you're not eligible for premium-free coverage, you'll pay $437 for Part A. The deductible is $1,364 for each benefit period. (A benefit period begins the day you're admitted as an inpatient in a hospital or skilled nursing facility (SNF). The benefit period ends when you have not received any inpatient hospital or SNF for 60 days in a row.) The average deductible for Part A is $1,364.

Part B - The standard Part B premium is $144.30, but tends to be a bit lower.  However, if you have a high income, your costs may be higher. The deductible is $197 for the year. Once you meet that deductible, you usually pay 20% of your Part B healthcare costs. 

Part C -  The average monthly Medicare Advantage premium is $23 for 2020. Deductibles vary by plan, so you want to make sure you understand the out-of-pocket costs when comparing plans. 

Part D (drug plan) - Most Medicare drug plans charge a monthly fee that varies by plan. The average monthly basic Part D premium for 2020 is $30. That's less than the $32.50 in 2019 and $33.59 in 2018. In fact, it's the lowest average since 2013. Deductibles vary, but no Medicare drug plan may have a deductible more than $435 in 2020. That's an increase of $20 from 2019. 

Beneficiaries no longer have to pay more for medication when they reach the so-called "donut hole." The donut hole was when a Medicare member reached a certain level of drug costs. They would have to pick up the costs during that period. However, Congress eliminated the donut hole, so you don't have to deal with that anymore. 

Where to get help

Visit Medicare.gov to get information about plans in your area or call 1-800-MEDICARE. You can also get help by contacting your State Health Insurance Assistance Program. The "Medicare & You" booklet is available for download on the Medicare website.

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Find Affordable Health Insurance Now!

Please enter valid Zip Code.
Please enter valid date.
You may be eligible for a government subsidy if your household income is under:
The Affordable Care Act (ACA) offers subsidies based on your household income, family size, and Qualifying Life Events.

You may qualify if...
One of the life events below has happened to you in the past 60 days:
  • I got married or divorced
  • I had a baby
  • A member of my family died
  • I moved to another state
  • i lost my job
  • I started a new job
  • I lost my health insurance coverage
and
Your income is under:
  • $45,960 - Individuals
  • $62,040 - Family of 2
  • $78,120 - Family of 3
  • $94,200 - Family of 4
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