The Centers for Medicare and Medicaid Services (CMS) recently announced that Texas will have a new plan structure in 2022. While Medicare will continue to offer prescription drug coverage, some plans may be less generous than others, depending on where you live.
Medicare and Medicare Advantage/HMO plans are managed by the Centers for Medicare & Medicaid Services (CMS), a Federal agency. The plans available through the Medicare.gov website have been approved by CMS for eligibility in their programs and coverage area.
In areas where the Medicare Advantage plans are more affordable and of equal or higher quality to a Medicare Original plan, a person may choose a Medicare Advantage Plan. For example, primary care doctors continue to be in high demand as medical professionals seek to attract and retain them.
Part A and B
Part A premiums will increase from $471 a month to $499 per month. In addition, the inpatient hospital deductible will rise from the current $1484 to $1559.
The co-insurance will increase from $371 per day to $389 per day. For hospitalization of between one and 60 days, you pay $0 for each day of hospitalization. For hospitalization of 91 days or more, you spend $778 for each additional day.
Part B premiums will increase from $148 a month to $170.10 a month. In addition, the Part B annual deductible will rise to $183.
Part C premiums will reduce from the current $21.22 a month to $19 a month. However, the Part C annual deductible will remain at $2,000.
These changes are small but impactful, and knowing about them will help you plan for the future. Most importantly, it’s important to note that Medicare Advantage and Part D plans that work with Original Medicare does not conflict with your other coverage choices. If you already have a Medicare Advantage or Part D health insurance plan, you do not need to replace it with an EPO Medigap plan.
Part D premiums will increase from $31.47 per month to $33.00 a month. The Part D annual deductible will remain at $400.
The most significant change to Part D is the Medicare drug coverage gap, known as the “donut hole.” Drug coverage currently ends once you and your plan have spent a certain amount of money on prescription drugs.
The out-of-pocket costs that enrollees pay between this point until the donut hole is completely closed will be changing in Part D plans beginning on January 1, 2022. As with most government programs, Medicare Part D is a public-private partnership.
In this case, the government covers the administrative costs, around twenty percent of total program costs each year. In exchange for providing the government with their expertise in providing prescription drug coverage to seniors and the disabled, Medicare Part D plan sponsors receive significant discounts on negotiated prices and administrative costs.
Medicare Advantage Premiums
Currently, Medicare beneficiaries who choose to enroll in a Medicare Advantage plan must pay an additional premium together with their Part B premium to offset the difference between what traditional Medicare pays and what Medicare Advantage plans to charge.
The new Texas Medicare changes will make it so that Medicare Advantage plans pay providers at least as much as they would if you were using Original Medicare. Part of why Medicare Advantage plans have been so cost-effective is because they weren’t paying providers as much money for services as Original Medicare does.
These are just some of the many 2022 Medicare changes in Texas. Be sure to talk to your insurance agent to see how these changes may impact you. The Medicare program has been a leading factor in helping millions of Americans receive medical and hospital coverage while they are of retirement age.
Medicare Parts A, B, and D are changing. While Part C (Medicare Advantage) won’t be affected, there will be some changes made to Parts A (Hospital Insurance), B (Supplementary Medical Insurance), and D (Prescription Drug Coverage).
You will have a new way to get support from a licensed health care professional when you need it most. Medicare premiums are changing. The early enrollment penalty is going away in 2022, but premiums are increasing faster than in recent years. Many preventive services will be either free or include a co-pay at no additional charge to you.