Medicare Changes 2022

What's new for Medicare and Medicare Advantage

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Every year, the Centers for Medicare and Medicaid Services (CMS) announce changes to the Medicare system, including changes to premiums, coverage, deductibles, and coinsurance amounts.

CMS has announced that standard premiums for Medicare Part B (most outpatient coverage), which almost everyone on Medicare pays, are $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. While higher than the previous year's $3.90 increase, the rise could be worse.

Medicare annual open enrollment runs from Oct. 15 to Dec. 7 every year.

Keep reading to learn about other changes, including historic low premiums for Part C (Medicare Advantage) and Part D (Prescription Drug) coverage as well as changes to Medigap plans for 2022.

Key Takeaways

  • Medicare Part A premiums increased to as much as $499, but many people qualify for premium-free coverage.
  • Medicare Part B standard premiums increased to $170.10, with a $233 deductible.
  • Select Medicare Advantage and Part D Prescription Drug plans have lower premiums and offer insulin for $35 per month.
  • The average premium for all Medicare Advantage plans is $19 per month.
  • Due to the COVID-19 pandemic, CMS extended numerous Medicare treatment waivers that will likely continue into 2022.

If you qualify for Medicare and are ready to look at plans, eHealth Medicare, an independent insurance broker and partner of Investopedia, has licensed insurance agents at <833-970-1255 TTY 711> who can help connect you with Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Part D plans.

Medicare Part A

Medicare Part A covers inpatient hospital, skilled nursing facility, and some home healthcare services and is premium-free for anyone who has 40 quarters or more of Medicare-covered employment. According to CMS, approximately 99% of Medicare beneficiaries do not pay a Medicare Part A premium.

If you have to pay for Part A coverage and have fewer than 30 quarters, your premium is $274 in 2022, a $15 increase from 2021. If you have between 30 and 39 quarters, your new premium is $499 a month in 2022, a $28 increase from 2021.

Medicare Part B

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. In 2021, Part B coverage began including up to 12 acupuncture visits in 90 days for chronic low back pain.

The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021.

Medigap

When you enroll in Medicare, you must choose between Original Medicare (Parts A and B) and a Medicare Advantage Plan (Part C). Original Medicare covers a lot of costs, but not all. So, most people who opt for Original Medicare also get a Medigap plan. Medigap policies, also known as Medicare Supplement Insurance, are sold by private companies. Premiums vary by company and coverage provided. Medigap is designed to fill the gaps in Original Medicare coverage and, in some cases, cover medical care when you travel outside the U.S.

As of Jan. 1, 2020, Medigap plans sold to new people with Medicare could no longer cover the Part B deductible. Due to this, Plans C and F are no longer available to people new to Medicare starting Jan. 1, 2020. You can keep your plan if you were already covered by one of these plans prior to Jan. 1, 2020. Exception: If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy Plan C or F.

Medigap Plans F and G High-Deductible

Medigap Plans F and G offer high-deductible plans in some states. With these plans, you must pay coinsurance, copayments, and deductibles up to the deductible amount, which is $2,490 in 2022—up from $2,370 in 2021.

Once you reach the deductible, the plan covers any costs for Medicare-approved services. Because of potentially high out-of-pocket costs, the premiums are typically much lower than for the standard Plan F or G options.

Medicare Part C (Medicare Advantage)

Medicare Advantage Plans (Part C) are a type of Medicare offered by private companies that contract with Medicare to provide all your Part A, B, and D (drug) benefits. Most of these plans also offer some attractive extras such as dental, vision, and hearing.

Medicare Advantage plans typically provide more benefits with lower premiums. The downside is that MA plans require you to choose “in network” providers. If you go outside the plan’s network or geographical area, you may pay more or not have coverage at all.

For 2022, CMS says the average premium for all Medicare Advantage plans is $19 per month. In addition, many Medicare Advantage plans are participating in the Part D Senior Savings Model, which offers insulin at no more than a $35 monthly copay. Moreover, some Medicare Advantage plans now offer coverage for end-stage renal disease (ESRD).

Plan Type Hospital Medical Drugs Extras Network
Original Medicare (Parts A & B) Yes (A) Yes (B) Limited No No
Medigap Supplemental Yes (A) Yes (B) No Limited No
Prescription Drug (Part D) No No Yes No Yes
Medicare Advantage (Part C) Yes Yes Yes Yes Yes

Medicare Part D (Prescription Drugs)

Medicare offers two ways to get prescription drug coverage—through Medicare Advantage (see above) and through a Part D Prescription Drug plan.

Part D Donut Hole

Medicare prescription drug plans have a coverage gap—a temporary limit on what the drug plan will cover. The coverage gap is often called the "donut hole." It kicks in after you and your insurer have spent a certain amount on medications in combined costs. Once that sum's been exceeded, you have to pay for at least a portion of your drugs out of pocket. But, most plans have limits on the amount you have to pay on your own in a given year, called the out-of-pocket threshold. Once you've exceeded that sum, your coverage kicks in again. Hence, the name "donut hole."

If it sounds absurd, it is—and lawmakers have been systematically trying to plug the donut hole for years. Today, you do pay a smaller percentage of the costs of your prescription drugs than you had to in the past during the coverage gap in your Part D plan. But you still pay more when you're in the hole.

For 2022, this coverage gap starts when you and your drug plan have spent $4,430 on covered drugs. Once you reach this level, you'll pay no more than 25% of the cost of the drugs (brand-name and generic), whether you buy your prescriptions at a pharmacy or online. While you pay at most 25% of costs during the coverage gap, almost the full price of your prescriptions count as out-of-pocket costs, though. This helps you get through the coverage gap faster.

Once you reach your 2021 out-of-pocket maximum for covered drugs ($7,050 in 2022), you enter the catastrophic coverage phase, in which you pay only a small coinsurance or copayment for covered drugs for the rest of the year.

2022 Premiums and Deductibles

Most of the premiums, deductibles, and coinsurance amounts for the different Medicare Parts have changed. According to our research, the amounts for 2022 are:

2022 Medicare Costs
Plan Costs
Part A Premium Free for most people. If you have to buy Part A, it costs up to $274 or $499/monthly, depending on how many months of Medicare taxes you've paid
Part A Deductible and Coinsurance $1,556 deductible for each benefit period
Days 1-60: $0 coinsurance for each benefit period
Days 61-90: $389 coinsurance per day of each benefit period
Days 91 and beyond: $778 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
Beyond lifetime reserve days: all costs
Part B Premium $170.10/monthly or higher, depending on your income
Part B Deductible and Coinsurance $233/monthly. After you meet your deductible, you pay 20% of the Medicare-approved amount for covered services
Part C Premium (Medicare Advantage) Varies by plan; averages $19 monthly
Part D Premium  Varies by plan; averages $33 monthly
Source: Medicare.gov

COVID-19 and Medicare Waivers

In addition to new premium, deductible, and coinsurance amounts, the COVID-19 pandemic led to some unplanned Medicare changes that will likely continue until the pandemic ends.

These waivers include but are not limited to:

  • Increased flexibility for Medicare to cover telehealth services.
  • Authorization for Medicare certification for home health services by physician assistants, nurse practitioners, and certified nurse specialists.
  • Increased Medicare payments for COVID-19-related hospital stays and durable medical equipment.

A complete list of Medicare waivers is available as a pdf file through CMS.

The Bottom Line

Familiarize yourself with the changes listed above and watch for changes in the works for 2023 and beyond, including plans to mandate lower drug prices and offer even more services to Medicare beneficiaries.

Is Medicare Expensive?

Medicare Part A is free for 99% of its current recipients. Other types of coverage, like Medicare Part B, C, D, or Medigap require premium costs, which depend on a number of factors.

How Did COVID-19 Impact Medicare?

The pandemic increased some Medicare costs, but also led to increased coverage. As a result, individuals with Medicare now have coverage for services like telehealth, home healthcare, and more.


Article Sources

Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in our editorial policy.
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  2. Centers for Medicare and Medicaid Services. "2021 Medicare Parts A & B Premiums and Deductibles." Accessed Dec. 30, 2021.

  3. Medicare.gov. "Joining a Health or Drug Plan." Accessed Dec. 30, 2021.

  4. Medicare.gov. "Medicare Costs at a Glance." Accessed Dec. 30, 2021.

  5. Centers for Medicare & Medicaid Services. "Part D Senior Savings Model (Insulin Savings) CommonQuestions& Answers," Page 1. Accessed Dec. 30, 2021.

  6. Centers for Medicare & Medicaid Services. "CMS Releases 2022 Premiums and Cost-Sharing Information for Medicare Advantage and Prescription Drug Plans." Accessed Dec. 30, 2021.

  7. Medicare.gov. "What Part B Covers." Accessed Dec. 30, 2021.

  8. Medicare.gov. "Acupuncture." Accessed Dec. 30, 2021.

  9. Medicare.gov. "Medigap & Travel." Accessed Dec. 30, 2021.

  10. Medicare.gov. "What's Medicare Supplement Insurance (Medigap)?" Accessed Dec. 30, 2021.

  11. Centers for Medicare and Medicaid Services. "Deductible Amount for Medigap High Deductible Options F, G & J for Calendar Year 2021," Page 1. Accessed Dec. 30, 2021.

  12. Centers for Medicare and Medicaid Services. "Deductible Amount for Medigap High Deductible Options F, G & J for Calendar Year 2022." Accessed Dec. 30, 2021.

  13. Medicare.gov. "How to Compare Medigap Policies." Accessed Dec. 30, 2021.

  14. Medicare.gov. "Medicare Advantage Plans." Accessed Dec. 30, 2021.

  15. Medicare.gov. "Open Enrollment Includes New Coverage Option for People with End-Stage Renal Disease (ESRD)." Accessed Dec. 30, 2021.

  16. Medicare.gov. "How to Get Prescription Drug Coverage." Accessed Dec. 30, 2021.

  17. Medicare.gov. "Costs in the Coverage Gap." Accessed Dec. 30, 2021.

  18. Medicare,gov. "Costs in the Coverage Gap." Accessed Dec. 30, 2021.

  19. Medicare.gov. "Catastrophic Coverage." Accessed Dec. 30, 2021.

  20. Centers for Medicare and Medicaid Services. "COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers." Accessed Dec. 30, 2021.