What's New for Medicare in 2021
State Health Insurance Assistance Programs • January 20, 2021
Medicare Advantage Plan costs
If you have a Medicare Advantage Plan, your plan administers your Part B coverage. Remember that most people with Medicare, whether they have Original Medicare or a Medicare Advantage Plan, pay the Part B monthly premium. Some people with a Medicare Advantage Plan may also pay an additional monthly premium for being enrolled in that plan.
If you have the same Medicare Advantage Plan in 2021 as you did in 2020, your plan should have sent you an Annual Notice of Change (ANOC) or Evidence of Coverage (EOC) notice explaining any changes for the coming year.
Review this notice to understand your plan’s costs, covered services, and rules. Contact your plan if you did not receive these documents in the fall or want another copy. If you chose a new Medicare Advantage Plan, you should get an EOC for the new plan. Review that document to understand the costs associated with the plan for 2021.
When can I change my Medicare coverage in 2021?
During the Medicare Advantage Open Enrollment Period (MA OEP), you can switch from your Medicare Advantage Plan to another Medicare Advantage Plan or to Original Medicare with or without a stand-alone prescription drug plan. The MA OEP occurs from January 1 through March 31. Changes made during this period are effective the first of the following month.
If you have Extra Help in 2021, you have a Special Enrollment Period (SEP) to enroll in a Part D plan or switch between plans.
This SEP is available once per calendar quarter for the first three quarters of the year (January-March, April-June, and July-September). If you use the Extra Help SEP to change your coverage, the change will become effective the following month.
If you qualify for another Special Enrollment Period, you may be able to make changes to your Medicare health/drug coverage. For example, you may have an SEP if you move outside of your plan’s service area or If you think a government employee made a mistake while assisting you. Call 1-800-MEDICARE to use an SEP, and contact your State Health Insurance Assistance Program (SHIP) by calling 877-839-2675 for more information.
Who can I contact if I have Medicare-related questions?
State Health Insurance Assistance Program (SHIP):
Contact your SHIP if you have questions about changes in costs and coverage of your Medicare in 2021. SHIP counselors provide unbiased Medicare counseling and assistance. Contact Juanita Beason with the East Texas Area Agency on Aging at juanita.beason@etcog.org or 1-800-442-8845.
Senior Medicare Patrol (SMP):
Contact your SMP (1-888-341-6187) if you believe you have enrolled in a plan based on misleading information or were enrolled in a plan without your knowledge. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.
1-800-MEDICARE (800-633-4227):
Call 1-800-MEDICARE to use an SEP, to request another copy of the Medicare & You handbook, or for more information about your 2021 coverage.
Medicare Advantage Plan or Part D plan:
If you have a Medicare Advantage Plan or Part D plan, contact your plan to ask about changes in your costs or coverage for 2021. You may also contact your Medicare Advantage Plan if you are using the MA OEP to switch plans.
Medicare Open Enrollment runs from October 15 until December 7, and people with Medicare will have more coverage options to consider. Plan costs and covered benefits have changed, so our Area Agency on Aging of East Texas (AAA) is offering benefits counseling assistance to encourage Medicare recipients to review their coverage choices and decide on the options that best fit their health needs. The changes Medicare recipients can make during Open Enrollment include: Joining a new Medicare Advantage Plan or Part D prescription drug plan Switching from Original Medicare to a Medicare Advantage Plan Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan) “Medicare Open Enrollment allows you the opportunity to review your healthcare plan and check on your financial well-being, which could also help save costs and coverage,” says AAA Benefits Counselor Nellie Spencer. “Call us and talk to an unbiased, qualified Benefits Counselor. We are also your State Health Insurance Assistance Program (SHIP) and available free of charge to go over your options.” For assistance, please call the Area Agency on Aging at 1-800-442-8845 to speak to a qualified benefits counselor. Appointments can be made over the phone, in a virtual meeting, or in person. Local Open Enrollment presentations: Benefits counselors will also be available for appointments at these community events during the Open Enrollment period. To reserve your spot, call the Area Agency on Aging at 1-800-442-8845. Walk-ins will be accepted. Palestine Resource Center for Independent Living, 421 Avenue A, Palestine, TX Date: Tuesday, November 4th Time: 9:00 am-3:00 pm George Washington Carver Community Center, 2303 Holland St., Marshall, TX Date: Thursday, November 6th Time: 10:00 am-2:00 pm Mt. Zion C.M.E. Church, 104 State Hwy. 64, Ben Wheeler, TX Date: Thursday, November 13th Time: 1:00 pm-3:30 pm First Christian Church, 1920 Beaumont St., Jacksonville, TX Date: Thursday, November 20th Time: 9:00 am-12:00 pm Be on alert for these Medicare Open Enrollment scams: There are no "limited time offers." Medicare or a health plan calls and wants to send you a new health card for $299. You receive a call about a refund from last year's premiums or your drug plan cost. An agent tries to sign you up for a plan that you don't need, isn't right for you, or doesn't even exist. Watch out for fake RX cards offering significant discounts with little or no benefits. You receive a call offering significant discounts on a new health insurance plan. Agents can NOT cold call you. Tips on how to stop fraud during Open Enrollment: If it's "too good to be true," it probably is. Don't trust all the ads you see on TV. Review the plan BEFORE you join. Even if you're not switching, review your current plan to ensure it covers your doctors. Medicare will never call or visit. Medicare will only send information via postal mail service. Guard your Medicare card and number like a credit card. Don't give out your Medicare number except to your doctor or other providers. Don't let someone push you into making a fast decision. If you receive a call, especially from a number you do not recognize or anyone requesting personal information, hang up immediately. Know your health care options. Get help from your family, the Medicare website, or your local State Health Insurance Assistance Program (SHIP), which for East Texas is the AAA. No health care plan is allowed to cold call. Medicare plans can be viewed and compared at www.medicare.gov .
The East Texas Council of Governments (ETCOG) is pleased to announce the appointment of Adrian Cornejo as the new Director of the Area Agency on Aging of East Texas (AAA). In this role, Cornejo will lead efforts to develop and coordinate services that support the health, independence, and quality of life of older adults across ETCOG’s fourteen-county region. Cornejo brings a strong background in healthcare leadership and military service. He most recently worked as an Account Manager for Humana’s Institutional Special Needs Plan program, where he partnered with skilled nursing facilities to improve care coordination, leading to a 20% reduction in hospital readmissions. Earlier in his career, Cornejo served in the United States Navy for nearly two decades, rising to the rank of Senior Chief Petty Officer and managing budgets exceeding $550 million while leading more than 350 Sailors and Marines. “Adrian’s leadership experience in both healthcare and the military has equipped him with the skills and dedication needed to serve East Texas seniors,” said ETCOG Executive Director David Cleveland. “His background in building partnerships and his deep commitment to public service make him a tremendous asset to our team.” Cornejo shared his enthusiasm for his new role, saying, “It is an honor to join ETCOG and to serve the seniors of East Texas. My goal is to build on the strong foundation already in place at the Area Agency on Aging and continue to expand access to services that help older adults and their families live with dignity and independence.” The AAA is administered through ETCOG and is part of a nationwide network created through the Older Americans Act of 1965. It provides a wide range of services, including information and referral, benefits counseling, case management, health education, senior nutrition programs, housing repair, caregiver support, and Ombudsman advocacy for individuals in long-term care facilities. These programs are designed to help older residents remain active and independent in their homes and communities for as long as possible.
