Changes to Medicare in 2021

021 is now full swing! If you are currently a Medicare client, there are some changes to the program that you might be affected by this year. Below, we gathered together a comprehensive overview of Medicare changes in 2021.

changes starting January 2021


Part A premiums, deductible, and coinsurance are higher for 2021.

Roughly 1 percent of Medicare Part A enrollees pay premiums; the rest get it for free based on their work history or a spouse’s work history. Part A premiums have trended upwards over time and they increased again for 2020 — although they are actually lower in 2020 than they were in 2010. For 2021, the Part A premium for people with 30+ (but less than 40) quarters of work history is projected to be $263/month, up from $252/month in 2020. For people with fewer than 30 quarters of work history, the premium for Part A is projected to be $478/month in 2021, up from $458/month in 2020.

Medicare Part B

Part B premium

The standard Part B premium is $148.50 for 2021. This is an increase of less than $4/month over the standard 2020 premium of $144.60/month.

Part B deductible

The Part B deductible is $203 in 2021 (up from $198 in 2020).

Part B high-income premium brackets

The income brackets for high-income premium adjustment for Medicare Part B will start at $88,000 for a single person.

Medicare Advantage, or Medicare Part C

The maximum out-of-pocket limit for Medicare Advantage plans is increasing to $7,550 for 2021.


Advantage, or Medicare Part C

Medicare Advantage plans are available for people with end-stage renal disease (ESRD) as of 2021.

Under longstanding rules, Medicare Advantage plans have been unavailable to people with end-stage renal disease (ESRD) unless there was an ESRD Special Needs Plan available in their area. But starting in 2021, Medicare Advantage plans are guaranteed issue for all Medicare beneficiaries, including those with ESRD. This is a result of the 21st Century Cures Act, which gives people with ESRD access to any Medicare Advantage plan in their area as of 2021. Many people with ESRD will still find that Original Medicare plus a Medigap plan and Medicare Part D plan is still the most economical option overall, in terms of the coverage provided.

Medigap Plan C no longer available

As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigap plan C is no longer available for purchase by people who become newly-eligible for Medicare on or after January 1, 2020. People who became Medicare-eligible prior to 2020 can keep Plan C if they already have it, or apply for those plans at a later date, including for 2021 coverage.

Medicare Part D

D deductible

For stand-alone Part D prescription drug plans, the maximum allowable deductible for standard Part D plans will be $445 in 2021, up from $435 in 2020. The out-of-pocket threshold (where catastrophic coverage begins) will increase to $6,550 in 2021, up from $6,350 in 2020. The copay amounts for people who reach the catastrophic coverage level in 2021 will increase slightly, to $3.70 for generics and $9.20 for brand-name drugs.

Access to insulin

Medicare beneficiaries with Part D coverage (stand-alone or as part of a Medicare Advantage plan) will have access to insulin with a copay of $35/month in 2021. This is expected to save beneficiaries several hundred dollars per year.

Part D donut hole no longer exists

However, a standard plan’s maximum deductible is increasing to $445 in 2021, and the threshold for entering the catastrophic coverage phase (where out-of-pocket spending decreases significantly) is increasing to $6,550.

How does this affect you?

The answer to that question changes from person to person. These changes might mean savings. Give us a call to review your needs and identify the best plan for you. We are available by phone (973) 715-9200, email (, or you can send us your questions by form on our website here:

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