Department of Family Services – Older Adults

Fairfax County, Virginia

CONTACT INFORMATION: Monday–Friday 8 a.m.–4:30 p.m.

703-324-7948
TTY 711

12011 Government Center Parkway, Suite 708
Fairfax, VA 22035

Trina Mayhan-Webb,
Division Director

What Changes Are Coming to Medicare in 2021?

Article by Mari de Leon, Program Coordinator, Virginia Insurance Counseling and Assistance Program

(Posted 2021 January)

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Fairfax Area Agency on Aging’s staff have established a virtual format to assist older adults who are enrolling in Medicare or needing help to identify appropriate insurance plans. 

Below are changes coming to Medicare in 2021. If you have questions, please contact the Virginia Insurance Counseling and Assistance Program (VICAP) at 703-324-5851, TTY 711.

The changes include:

  • The Part B deductible is $203 in 2021 (up from $198 in 2020). 
     
  • Part A deductible is $1,484 an increase of $76 from $1,408 in 2020. 
     
  • Medigap Plans C and F are no longer available for purchase by newly eligible Medicare beneficiaries. 
     
  • A separate reminder letter as part of the Initial Enrollment Period. Starting in late 2020, the Centers for Medicare & Medicaid Services (CMS) will send a separate reminder letter as part of the Initial Enrollment Period, which will provide information for individuals to learn more about Medicare, review benefits, and make their coverage choice. The reminder will follow the package sent to individuals auto-enrolled into Parts A and B and will be sent one month before Medicare coverage starts.
     
  • Medicare illustrative graphicThe opportunity for Medicare beneficiaries with ESRD (end–stage renal disease/kidney failure) to enroll in a Medicare Advantage plan. Beginning in 2021, and as required by the 21st Century Cures Act of 2016, Medicare beneficiaries with ESRD (end-stage renal disease/kidney failure) will have the opportunity to enroll in a Medicare Advantage plan. While dialysis coverage will be offered by Medicare Advantage plans, dialysis costs will be reimbursed by Parts A and B. In addition, Medicare Advantage plans will not be responsible for organ acquisition costs of kidney transplants.
     
  • Coverage of acupuncture for chronic back pain (which began under Original Medicare in 2020 and is slated to extend to Medicare Advantage in 2021). Medicare Part B began covering up to 12 sessions of acupuncture treatment for those with chronic lower back pain (pain lasting 12 weeks or longer) that has no identifiable systemic cause (not associated with metastatic, inflammatory, or infectious disease), and is not associated with surgery or pregnancy. Beneficiaries must receive the 12 treatment sessions within a 90-day period. Medicare will cover an additional eight sessions if the beneficiary shows improvement. Absent improvement, no additional treatment will be covered. Under Original Medicare, beneficiaries will pay a 20% coinsurance for acupuncture services, and no more than 20 acupuncture treatments will be covered each year.
     
  • A prior authorization requirement for procedures that include blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. 
     
  • Under the legislation (SB250) that Virginia enacted, Medigap insurers in the state will have to offer at least one plan on a guaranteed-issue basis to Virginia residents who become eligible for Medicare prior to the age of 65 due to a disability (insurers are likely to select Plan A). And people who were already enrolled in Medicare prior to 2021 will have a one-time six-month open enrollment period, starting January 1, 2021, during which they can sign up for a Medigap plan under the new rules.

This article is part of the Golden Gazette monthly newsletter which covers a variety of topics and community news concerning older adults and caregivers in Fairfax County. Are you new to the Golden Gazette? Don’t miss out on future newsletters! Subscribe to get the electronic or free printed version mailed to you. Have a suggestion for a topic? Share it in an email or call 703-324-GOLD (4653).


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