Why You Shouldn’t Ignore Medicare Open Enrollment This Year


October 15, 2020

Medicare Open Enrollment started today. And if you’ve already got a Medicare plan, then you may know that this is your one guaranteed chance each year to make changes to your health insurance for the coming year. If you didn’t, you do now.

There are several enrollment periods for Medicare, from the initial window when you first became eligible to the Medicare Advantage Open Enrollment Period. It’s hard to keep up — even for the professionals.

But this is the big one. 

Annual open enrollment is everyone’s chance — everyone with Medicare already, that is — to update their coverage for the next year. You don’t want to miss it.

Not sure what the point is if you already have coverage you like? That’s understandable. Buying health insurance can be taxing, even if you’ve had a Medicare plan for years.

But as Medicare Advantage enrollment becomes increasingly popular, you’re more likely now to find broader benefits, lower costs and more options overall than ever before. The Centers for Medicare and Medicaid Services (CMS) estimates that 42% of Medicare members will choose a private plan  in 2021 — nearly half of the Medicare population.

With higher enrollment comes motivation for Medicare Advantage carriers to compete for your business, and that’s good news for your wallet and your benefits package.

Need a few more reasons to hop online and look for a new plan in 2021? Here’s why you shouldn’t ignore Medicare Open Enrollment.

Premiums for Medicare Advantage and Part D plans are even lower than last year.

Premiums for Medicare Advantage plans have gone down substantially over the years. 

That trend continues in 2021, with the CMS projecting average premiums for Medicare Advantage at $21 a month. Our own analysis of CMS state data has premiums slightly higher, at around $26 a month.

Even better, nearly every Medicare member (99.3%) has access to at least one Medicare Advantage plan with a $0 premium.

But however you look at it, low premiums mean better deals on the kind of coverage you can’t get with Original Medicare. 

Keep in mind that Medicare Advantage plans cover all of the same benefits as Original Medicare. That’s a federal requirement. 

Beyond this requirement, private Medicare plans have the flexibility to cover other benefits, and plenty of plans take advantage of that flexibility. You’ll also typically find coverage for things like prescription drugs, dental and vision, hearing aids and exams, and more.

You’ll always pay your Part B premium no matter what kind of Medicare coverage you get. But with Medicare Advantage, you may pay an extra premium — or none at all — for a host of added benefits.

If you have Original Medicare and a Part D drug plan, there’s good news for you in 2021, too. The CMS is reporting a basic premium of around $30.50 a month for next year. But that’s the basic premium, not the average or the lowest. 

Our CMS state data analysis found that on average, the lowest Part D premium across all 50 states and D.C. was just over $7 a month in 2021.

You might save money on insulin, too.

There’s more good news for people with Part D who need insulin. For 2021, the CMS is launching a program that caps insulin costs at $35 a month for participating plans. 

Between standalone Part D drug plans and Medicare Advantage plans that cover prescriptions, there are 1,910 participating plans according to our analysis of the CMS data. Of those, most are Medicare Advantage plans with prescription drug coverage (1,456) while the rest are standalone Part D plans (454).

You may pay even less depending on the plan you buy.

The cap is $35 for participating plans, but that could mean some plans offer even lower monthly copays. If you take insulin, this year is a good year to browse new lower-cost plans.

There are about 5,000 Advantage plans on the market for 2021.

Not every Medicare Advantage plan is available in every state. But there are a total of nearly 5,300 plans available when you add up all the plans in each state and D.C. 

If you do a straight average (dividing total plans available by the number of states and D.C.), it’s about 104 plans per state. Availability, though, depends entirely on where you live. 

Some states have hundreds of plans, like Florida with 527. Others have barely more than a handful, like Delaware with 23. And in Alaska, there aren’t any Medicare Advantage plans for 2021.

But with so many options this year, it’s worth taking another look at what you’ve got and comparing it to new plans where you live. More choices typically means that you’ll find lower rates, since these plans are competing for your business.

States with more plan options tend to have lower premiums, overall, than states with fewer. But that’s not a guarantee. 

Availability also depends on your zip code, not just your state. More populous areas may have more options and again, possibly lower rates. That’s why it’s important to use your zip code when browsing plans, too.

And lots of those plans cover even broader benefits than before.

The Centers for Medicare and Medicaid Services mentions in its state data briefing that Medicare Advantage plans will have the option to offer “innovative benefits.” These could include reduced cost sharing, rewards and incentives programs, and wellness and healthcare planning according to the CMS.

Medicare Advantage plans cover a broader range of benefits than Original Medicare already, including things like:

  • Prescription drugs
  • Dental and vision coverage
  • Hearing aids and exams
  • Telehealth visits
  • Access to 24/7 nurse phone lines
  • Post-hospital meal delivery
  • Gym memberships

Last year, Medicare Advantage plans were given greater flexibility than they already had to come up with ways to improve care for people with chronic health conditions. Pest control services, for example, could now theoretically be covered by private Medicare plans. 

This year’s expansion on that concept means more private plans may include an even broader array of benefits. You might not need a gym membership, but you might need transportation to and from doctor’s appointments or access to telehealth services from your home. 

When you’re looking at the kind of coverage you need for 2021, consider some of these extra perks and how they might add value to your plan — and your life.

If you have ESRD, you can now buy a Medicare Advantage plan.

If you have end-stage renal disease (ESRD), you can now buy a Medicare Advantage plan without restrictions for the first time. Before 2021, people with ESRD could only get a private Medicare plan if they had the plan before they were diagnosed or they were grandfathered in from employer coverage.

That changes for next year.

During open enrollment, you can now buy Medicare Advantage even if you have ESRD, and that’s big news. ESRD affects more than 500,000 Medicare members, only a quarter of whom currently have MA plans.

Private plans may help you manage your health.

Just make sure your providers are in the network for any plan that you choose. Medicare Advantage plans typically have networks — though not always — so check the plan’s network carefully for the providers you need.

Plus, even if you love your plan, you should always take another look during OEP.

Over the next seven weeks, you have a guaranteed chance to look at Medicare options for 2021, figure out what you need from a health plan and make those changes for coverage starting in January.

This is an important time.

Consider how your healthcare needs might have changed over the last year. Annual enrollment gives you an opportunity to make sure that your current plan meets your needs and your budget.

With over 5,000 Medicare Advantage plans on the market, new benefits for next year and lower monthly premiums, now’s a great time to see what’s out there. You may not find something that’s better than what you have already, but you won’t know until you take a look.