2021 Medicare Highlights
Each year, if needed, the Centers for Medicare & Medicaid Services (CMS) adjust Medicare’s premiums, deductibles, and copays. As a reminder, Medicare Part A covers hospital expenses, and Medicare Part B covers other types of medical expenses, including physician services, certain home health services, and durable medical equipment. Medicare Part D covers prescription drugs.
Part B premium and deductible for 2021
Most people do not pay a monthly premium for Medicare Part A if they or their spouse paid Medicare taxes while working. However, to be covered under Medicare Part B, you must pay a monthly premium (in most cases, deducted from your Social Security benefit). As required by law, the standard monthly premium is set each year at 25% of the cost for senior beneficiaries. The government pays the remaining 75%.
Most Medicare beneficiaries—including those who will enroll in Part B for the first time in 2021—will pay a Part B premium of $148.50. However, some people who get Social Security benefits pay less ($130 on average), and others may pay more if their 2019 modified adjusted gross income is above a certain amount. More about Part B premium amounts can be found on the Part B Costs page on www.medicare.gov.
The Part B deductible is $203 for 2021. This is the amount you must pay for health care before Medicare begins to pay for covered services and products.
The chart below compares some of your costs in 2020 to 2021. The Health Options Program is designed to pay some or all of these deductibles and coinsurances. For example, the HOP Medical Plan pays your Part A deductible and coinsurance for stays in hospitals and skilled nursing facilities, as well as the Part B deductible. The Value Medical Plan also pays 100% of Medicare’s hospital deductible and daily copays but only after you pay the first $300.
| What you pay for | 2020 | 2021 |
|---|---|---|
| First-day hospital deductible | $1,408 | $1,484 |
| Coinsurance for days 1-60 of a hospital stay | $0 | $0 |
| Coinsurance for days 61-90 of a hospital stay | $352/day | $371/day |
| Coinsurance for days 1-20 in a skilled nursing facility | $0 | $0 |
| Coinsurance for days 21-100 in a skilled nursing facility | $176/day | $185.50/day |
| What you pay for | 2020 | 2021 |
|---|---|---|
| Standard monthly premium for most Medicare beneficiaries | $144.60 | $148.50 |
| Standard monthly premium for new enrollees in 2021 and certain other Medicare beneficiaries | $144.60 | $148.50 |
| Deductible | $198 | $203 |
| Coinsurance | 20% | 20% |
Contact the HOP Administration Unit for assistance with your questions.