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What Family Caregivers Need to Know About Medicare Changes

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medicareenrollment.pngAs family and friends grow older, you may find yourself in the role of caregiver.

You could be asked to make decisions of all kinds such as assisting with daily activities, health issues, treatments or help with Medicare. When you understand the new changes in Medicare and the various enrollment periods, you’ll be better equipped to help guide your loved ones in making Medicare decisions to best meet their needs.

Changes in Medicare for 2020
Some of the changes happening next year will affect all Medicare beneficiaries, while others will apply to individuals on certain plans. This year the Centers for Medicare & Medicaid Services (CMS) updated their handbook, which beneficiaries receive in the fall.

In August 2019, CMS announced that not only was the Medicare Plan Finders Tool  improved, only the new tool would be available for use. Not only was the “coverage wizard” available to make determining the right plan easier, available benefits are highlighted on the initial results screen. This allows a Beneficiary or their family to ensure they only examine policies that fit with their coverage needs. All of this makes it easier than ever to determine which Medicare Advantage plans are applicable.

Medicare Part A and B Increases in 2020
The 2020 Medicare changes will take place January 1st and will be in effect all year. Once again there will be an increase in Part A and Part B premiums and deductibles.

Part A Premium Increases
Most beneficiaries are not required to pay a Medicare Part A premium. However; if your loved one has fewer than 40 quarters of employment, a monthly premium payment may be mandatory.

Currently the Medicare regulation is:

  • If a beneficiary had at least 30 quarters of employment or was/is married to someone with at least 30 quarters of coverage, a beneficiary may buy into Part A at a reduced monthly rate. The rate for 2020 is projected to be .
  • Beneficiaries that have exhausted other entitlement will pay the full premium which is projected to increase to per month in 2020.

Part A Deductible Increases
The 2020 Part A deductible increase is projected to be ,420. Beneficiaries with Traditional Medicare as their only coverage will be expected to pay this if admitted to the hospital.

Beneficiaries will continue to pay a coinsurance projected to increase to per day for the 61st through 90th day of hospitalization in 2020. For lifetime reserve days, it’s projected to be per day.

For Medicare recipients in skilled nursing facilities the projected daily coinsurance is expected to be .50, for days 21 through 100 of extended care services in a benefit period.

Part B Increases
For Part B the projected 2020 premium is .30 each month, up .80.

The Part B deductible is projected to increase from to . Beneficiaries with a Medigap Plan C or Plan F have coverage for this deductible.

Medicare Advantage plan enrollees have low copays and deductibles that won’t necessarily increase with the Part B deductible.

Help Affording Medicare Increases
Having additional coverage with Medicare will help cover the costs of many of these increases. Talking to a licensed insurance expert may help you gain confidence in your loved one’s health care coverage.

Medicare Open Enrollment Period
The Medicare Open Enrollment Period (OEP) takes the place of the Medicare Advantage Disenrollment Period (MADP), which used to be January 1 through February 14 every year.

Prior to 2019 the MADP only allowed beneficiaries to disenroll from their Medicare Advantage coverage and switch back to Original Medicare. That changed in 2019 and now Medicare Advantage beneficiaries can switch to another MA plan or switch back to Original Medicare.

What to do During OEP:

  • Switch from one Medicare Advantage plan to another
  • Only one change can be made during this enrollment period, so make the change count.
  • Disenroll from a Medicare Advantage plan and switch back to Original Medicare, with or without a Part D Prescription drug plan.

This new law will allow beneficiaries to make Medicare Advantage plan changes. However; it’s important to understand that switching stand-alone Part D Prescription Drug plans during the Medicare OEP is not allowed. Enrollment in a Part D plan is allowed if switching back to Original Medicare, but switching from one Part D to another is not allowed.

Beneficiaries enrolled in a stand-alone Part D plan will need to make changes during AEP (October 15 through December 7 of every year). Compare AEP vs OEP in detail here.

Each year by September 30th, Medicare Advantage recipients will receive an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their insurance carrier for their Medicare Advantage and Medicare Prescription drug plan providers.

When this information is obtained, it’s important to review the changes and determine if coverage adjustments are needed. CMS posts Medicare plan changes every October, months before the changes go into effect. This is a good time to start reviewing what is available in your area and determining what is needed for your loved one. is a reliable resource for beneficiaries, caregivers and other family members to compare plans, look up information and learn more about Medicare.

Author: LaNita Knoke

LaNita Knoke is a Registered Nurse with more than 25 years of clinical experience including direct care and clinical business. As a healthcare strategist, she is responsible for the healthcare adjacency strategy for the Home Instead Senior Care global network, which includes a focus on care transitions programs, community resources, and understanding of home care as it relates to the clinical continuum.


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