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Do Medicare Benefits Change Every Year?

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Summary: Medicare benefit changes are more likely if you have a Medicare Advantage plan or a stand-alone Medicare Part D prescription drug plan. Learn when these changes happen and how you can stay on top of your Medicare benefit details.

Medicare benefits: how often do they change?

Original Medicare (Part A and Part B) benefits don’t change without government legislation. These are not usually frequent or major changes. Medicare Part A and Part B benefits don’t usually change much, but their monthly premiums and deductibles (and possibly other costs) can change every year.  Many people don’t pay a premium for Part A.

Medicare benefits: Annual Notice of Change

If you have a Medicare Advantage plan or a stand-alone Medicare Part D prescription drug plan, you’ll get an Annual Notice of Change (ANOC). The ANOC is usually sent in September to let members know about Medicare plan benefit changes that begin the following January.

As you’re reviewing your Medicare benefits, the ANOC can be a valuable tool. You can use the ANOC to see if your Medicare plan benefits, and what you’re paying for them, are still in line with your health-care needs. Want to see if a different Medicare Advantage plan or Medicare prescription drug plan might serve your needs better? You can compare plans in seconds, right from this page. All you need to do is enter your zip code to get started.

Your Medicare health or prescription drug plan’s ANOC includes changes to costs, coverage, and service areas. When you get your notice, you can review these Medicare plan benefit changes. If you want to change plans, you will have time to find another plan with Medicare benefits that are a better fit for you.

The Annual Election Period (AEP) begins on October 15 each year and runs through December 7. This is the time when you can switch to a different Medicare Advantage plan, or a new Medicare prescription drug plan. You may be able to make other coverage changes during the AEP.

All Medicare health and prescription drug plans must send this notice by September 30. If you do not receive your notice, you should contact your plan for more information.

Who gets an Annual Notice of Change?

You will receive the ANOC if you have a Medicare health plan, such as a Medicare Advantage plan. If you have a stand-alone Medicare Part D prescription drug plan, you’ll also get an ANOC.

Medicare Advantage plans are an alternative way to receive your Original Medicare benefits. Most of them include prescription drug benefits. On the other hand, if you decide to stay with Original Medicare, you can enroll in a stand-alone Medicare Part D prescription drug plan.

Medicare Advantage and Medicare prescription drug plans are offered by private, Medicare-approved insurance companies. You still pay your Medicare Part B monthly premium, along with any premium the plan may charge.

Medicare benefit changes you might expect

Changes to look for in your ANOC might include:

  • The insurance company might switch the name of the plan
  • The service area may change
  • Out-of-pocket costs related to the plan (premiums, deductibles, copayments) might change
  • The formulary (list of drugs covered under the plan) could be altered

Read your ANOC carefully and address questions about your Medicare benefits with your plan provider if they arise.

New optional Medicare Advantage benefits

Medicare Advantage plans were allowed to start offering some new Medicare benefits in 2019. These are optional, and plans don’t have to offer these extra benefits.

These bonus benefits might include home care services like house cleaning, meals delivered to the home, or transportation for non-medical purposes. The benefits may be offered to Medicare beneficiaries who are chronically ill and can’t perform the tasks themselves – you have to meet certain qualifications to be eligible. Ask your plan if you have questions. Or, start comparing plans instantly to see what extra benefits they might offer. Just enter your zip code on this page as the first step.

There have been Medicare benefit changes to Medicare prescription drug plans as well. Congress passed a spending bill to close the coverage gap (“donut hole”) on prescription drugs in 2020. The donut hole is a coverage gap that sometimes requires members to pay higher prices for prescription medications after they reach a certain spending level each year. With the coverage gap gone, you may pay less for your brand-name medications than in past years, in some cases.

Medicare benefit changes do sometimes happen, especially with Medicare Advantage and stand-alone Medicare prescription drug plans. So you may be wise to compare plans in your area every fall. It’s easy with eHealth’s no-obligation plan comparison tool. Simply enter your zip code and follow the prompts to discover plans in your service area.

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