2022 Medicare Plans Are Changing
Make sure your plan still has all of your needs covered and learn about new benefits.
Answering All of Your Questions About Medicare Annual Enrollment
If you're ready to join the 60 million Americans enrolled in Medicare1 but unsure where to begin, you're in the right place! You've put in a lot of hard work, time, and energy over the years to receive your Medicare health benefits. Our goal is to make sure you fully understand all that Medicare offers (and what it doesn't). That way, you'll be fully prepared for Medicare annual enrollment, which takes place every year from Oct. 15 to Dec. 7. The more you know, the less likely you'll miss out on the benefits you've earned.
You're certainly not alone if you're overwhelmed about Medicare's annual enrollment process! In this article, we'll guide you through what Medicare covers, eligibility, costs, how and when to enroll step by step, and frequently asked questions about enrollment. Worried about budget-busting deductibles and coinsurance? We'll also go through the details of supplemental insurance to help ease out-of-pocket expenses.
Think of Medicare insurance like a tricky crossword puzzle. Many pieces go into the Medicare puzzle to make it complete. We all know crossword puzzles can be frustrating, so let's dive into what makes up Medicare insurance.
The Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program. However, Social Security processes your application for Original Medicare (Part A and Part B).2
Original Medicare is a federal insurance program with two parts:
While Original Medicare through the government is a great starting point, it won't cover everything! Additionally, Original Medicare doesn't have a limit for out-of-pocket costs, which means your cost-sharing responsibility will accumulate without a cap. Medicare also contracts with private insurance companies to offer add-on or bundling options such as these:
We'll take a closer look at all of these options later in this article.
Read more about why we have Medicare Part A and Part B and watch our “Introduction to Medicare” video below. You'll be a Medicare expert in no time!
To be eligible for Medicare Part A and Part B, you must meet at least one of the following criteria:
Pro Tip: Find out if you're eligible for Medicare and what your estimated monthly premium will be by visiting the Medicare.gov eligibility calculator.
With Original Medicare, you can go to any doctor or hospital in the U.S. that takes Medicare. Below, we'll look at what Original Medicare (Parts A and B) covers.3
Remember, Medicare Part A and Part B covers some hospital and medical expenses, not all. If you need a service that Part A or Part B doesn't cover, you'll have to pay out of pocket. Don't panic — there are other options to fill these potentially costly gaps.
These are some of the major items and services that Original Medicare doesn't cover:4
Did You Know: Most health insurance plans don't pay for long-term care. Our long-term care for seniors guide details long-term care insurance options and costs.
Let's face it. Researching and understanding the ins and outs of Medicare can be complicated. There are several important things you need to know before you enroll to ensure that you receive the best coverage possible. Watch the video with our Editor-in-Chief, Jeff Hoyt, as he covers things you might not know about Medicare that could hurt you.
Medicare Part A and Part B come with several cost-sharing expenses. It's important for Original Medicare enrollees to know there is no yearly limit for out-of-pocket expenses.5 Unless you have additional coverage, such as a Medigap plan, you may face extensive health care costs, depending on your needs. The chart below looks at the major out-of-pocket expenses with Original Medicare.
|Plan||Expense type||Out-of-pocket cost|
|Medicare Part A||Inpatient hospital deductible||The 2021 Medicare Part A annual deductible is $1,484 for the first 60 days of Medicare-covered inpatient hospital care.|
|Medicare Part A||Coinsurance||Should your inpatient hospital care continue past 60 days, you’ll be responsible for daily coinsurance based on the duration of your hospital stay.|
|Medicare Part B||Monthly premium||The standard Medicare Part B premium for 2021 is $148.50.|
|Medicare Part B||Annual deductible||The annual deductible for Part B beneficiaries for 2021 is $203.|
|Medicare Part B||Coinsurance||Part B enrollees pay 20 percent of the Medicare-approved amount for all Part B services.|
Unsure when you can sign up for a Medicare health or drug plan? With so many older adults living on a fixed income or surviving solely on Social Security, the last thing you want is to face late enrollment penalties.
Avoid unnecessary fees by signing up for Medicare during the proper enrollment periods.
Medicare plan pricing, coverage, and provider networks can change on an annual basis. This is why it's so important to review your Medicare selections every year. Never set it and forget it!
If you're a Medicare newbie, our Medicare step-by-step guide will walk you through how to sign up for Medicare online or over the phone with the Social Security Administration (SSA).
Did You Know: Enrolling in your Medicare benefits online allows you to complete the application at your own pace from the comfort of your home. Need to take a break? You can save your online application and come back to it!
FYI: The Social Security Administration has suspended face-to-face service nationwide until further notice.9 If you have questions about your online application or are more comfortable speaking with a representative, contact the SSA at the phone number listed above.
It may come as a shock to learn that Original Medicare doesn't cover some of the health-related needs of older adults. The good news is that Original Medicare isn't your only option for health care coverage! You have the power to choose additional private insurance coverage tailored to your needs and budget.
Medicare Supplement Insurance, Medicare Part C, and Medicare Part D plans are available from private companies that contract with Medicare.
Medicare Supplement Insurance policies, also known as Medigap, help fill the gaps for Original Medicare's out-of-pocket expenses such as copayments, deductibles, and coinsurance. As you shop for Medigap plans, know that the insurance companies must offer the same benefits for each plan. For example, Medigap Plan A through Aetna will be identical to Plan A through UnitedHealthcare.
The six-month Medigap open enrollment begins the month a senior turns 65. Adults under the age of 65 with end-stage renal disease or a disability may be eligible for Medigap plans.
During open enrollment, insurance companies cannot deny you based on preexisting conditions or charge you more because of them.
Our comprehensive guide to Medicare Supplement Insurance walks you through Medigap plan pricing and coverage, along with how to find the best plan to meet your health care needs.
Just like Medigap, Medicare Part C is offered through private insurance companies. Medicare Part C, also known as Medicare Advantage, bundles Medicare Part A, Part B, and Part D (Prescription Drug Plan). Some Medicare Advantage plans offer extra benefits, like vision, hearing, and dental.
Keep in mind that Medicare Advantage and Medigap plans are not the same. Unsure which private insurance plan is right for you? Our research team details the pros and cons of Medicare Advantage and Medigap to help you make an informed decision.
As you prepare for Medicare enrollment, it's important to think about your prescription medications and how you'll pay for them. Prescription drugs are not covered under Original Medicare, and the out-of-pocket costs can quickly add up.
Every Medicare enrollee gets the opportunity to enroll in a separate Medicare Prescription Drug Plan (PDP). Our list of the best Medicare Part D providers is a fantastic starting point to explore!
As we age, prescription drugs may be filling our medicine cabinets. Jeff Hoyt, our editor-in-chief, explains several ways to save on prescription drugs, including State Pharmaceutical Assistance Programs (SPAPs) and Patient Assistance Programs (PAPs) below.
Medicare only pays for dental in very rare instances. Medicare Part A will pay for certain dental services that you get in a hospital if you need emergency or complicated dental procedures.10
Did You Know: Some dental plans require a waiting period before covering major dental work such as crowns or bridges. Our team researched the best dental plans for seniors to help you find the right one for your needs.
The rest of your dental care — such as cleanings, dentures, dental plates, and tooth extractions — comes out of your pocket. Many Medicare Part A and Part B enrollees opt for a private dental plan to lessen these expenses.
We need to take care of our eyes as we age. Older adults may face glaucoma, age-related macular degeneration, and cataracts. Adding a vision insurance plan to your Medicare coverage can lessen the worry about unexpected expenses. Head to our guide to the best vision insurance for seniors for a breakdown of the top-ranked vision plans for older adults.
Just say no to procrastination when it comes to enrolling in Medicare and supplement insurance! According to Medicare.gov, if you miss open enrollment, you may pay the following hefty penalties or, in the worst-case scenario, be denied coverage.
There are two federally run parts of Original Medicare: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). In addition to Part A and Part B, Medicare contracts with private insurance companies to offer Part C (Medicare Advantage) and Part D (Prescription Drug Plan).
Any individual who is eligible for Medicare Part A is also eligible for Medicare Part B. Keep in mind that while Medicare Part A is free for most individuals, Medicare Part B has a monthly premium.
Yes, even if you have VA benefits, you should enroll in Part A and Part B when you turn 65. The U.S. Department of Veterans Affairs does not recommend that veterans cancel or decline coverage in Medicare (or other health care or insurance programs) solely because they are enrolled in VA health care.
From the experts: Learn more about the wide range of VA benefits available to qualifying veterans in our veteran care guide.
Several state-run Medicare Savings Programs are available to low-income older adults struggling to pay premiums, deductibles, and copays. Head over to our Medicare Saving Programs guide to learn more.
If you're receiving Social Security benefits, your Medicare costs will automatically be deducted from your Social Security check. If you're not receiving benefits yet, you'll get a bill for your Medicare premiums in the mail.
There are four ways to pay your monthly premium. You can pay through …
Don't forget: Your Medicare bill will arrive around the 10th of each month. Your Medicare premium bill is due by the 25th of each month.
Both of these federal programs are in place to support the needs of adults age 65 or over and individuals with disabilities. However, the two programs support different needs. Medicare's role is to provide health insurance. Social Security's role is to provide financial support based on factors such as your earnings and work history.
Have you reached information overload? From costs and coverage to deductibles and penalties, it's easy to fall down the Medicare rabbit hole! Explore these Medicare resources to make sure you understand all that Medicare has to offer (and its limitations).
With 10 Medigap plans to choose from (eight if you became eligible for Medicare after Jan. 1, 2020), it's important to understand what each plan covers. This is especially crucial if you have ongoing health challenges. Our research team has put together the best Medigap resources to help you along your journey.
The plethora of insurance companies offering Medicare Supplemental Insurance plans can make your head spin! Explore our in-depth reviews to find out the pros and cons of each provider.
Since graduating from Harvard with an honors degree in Statistics, Jeff has been creating content in print, online, and on television. Much of his work has been dedicated to informing seniors on how to live better lives. As Editor-in-Chief of the personal… Learn More About Jeff Hoyt
Center for Medicare & Medicaid Services. (2021). Medicare Beneficiaries at a Glance.
Social Security Administration. (2021). Medicare.
Medicare.gov. (2021). Inpatient hospital care.
Medicare.gov. (2021). What’s not covered by Part A & Part B?
Medicare.gov. (2021). Compare Original Medicare & Medicare Advantage.
Medicare.gov. (2021). 2021 Medicare Costs.
Medicare.gov. (2021). When does Medicare coverage start?
Social Security Administration. (2021). Special Enrollment Period (SEP).
Social Security Administration. (2021). Social Security Office Locator.
Medicare.gov. (2021). Dental services.
U.S. Department of Veteran Affairs. (2021). Health Benefits.