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Do My Medicare Benefits Change Every Year?


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Summary: Medicare benefits generally don’t change very much year to year. This means most of what is covered in 2020 was also covered in 2019, 2018, 2017, and so forth. What may change from year to year is the amount you pay in premiums, deductibles, and copayments/coinsurance. Sometimes these amounts go up, as you may expect, and sometimes they actually go down.

Also, historically, when Medicare benefits change, it’s usually to expand the program, not to reduce it.

What Medicare benefits are already covered?

Original Medicare (Part A and Part B) generally covers:

  • Inpatient hospital care
  • Skilled nursing facility care
  • Hospice care
  • Limited, part-time home health care
  • Doctor visits
  • Durable medical equipment, like walkers and wheelchairs
  • Inpatient and outpatient mental health
  • Ambulance services

Medicare Advantage plans are a way to get your Medicare coverage from a private, Medicare-approved health insurance company. Medicare Advantage plans must cover everything that Original Medicare covers.

Can my Medicare Advantage plan change my Medicare benefits?

Medicare Advantage plans can change certain benefit details, such as cost information or which extra benefits they offer. Generally these changes can only happen once a year.

Your Medicare Advantage plan will send you an Annual Notice of Change every fall. You may want to read this notice to see if your Medicare benefits have changed under the plan. Note, however, that your Medicare Part A and Part B benefits can’t change under Medicare Advantage, unless the government changes them across the board.

Have there been any major changes to Medicare benefits?

Medicare was signed into law in 1965. Since then, the biggest change may have been the addition of the Medicare Part D prescription drug benefit in 2006. Although Original Medicare (Part A and Part B) still doesn’t include coverage for most prescription drugs you take at home, you can get prescription drug coverage through a stand-alone Part D prescription drug plan or a Medicare Advantage prescription drug plan.

Medicare Advantage plans may offer more supplemental Medicare benefits not covered by Medicare Part A and Part B. If you qualify for these benefits, Medicare Advantage plans can now offer:

  • Adult day health services
  • In-home support services
  • Meal delivery
  • Grocery shopping
  • House cleaning to reduce asthma attacks
  • Transportation to doctor appointments

Will my Medicare benefits change for my Part D coverage?

Your Medicare Part D prescription drug plan will have a formulary, which is a list of covered prescription drugs. This formulary may change, as there is constant research and new information in the pharmaceutical field.

However, the government generally protects you from sudden, negative changes to your Medicare benefits and prescription drug coverage.

Here’s an example of how the government might protect your Medicare benefits under Part D. Usually, a Medicare prescription drug plan can’t just take a medication off its formulary anytime. Typically plans have a certain period every year when they can make changes. But if the Food and Drug Administration declares a prescription drug unsafe, or if a manufacturer removes a medication from the market, plans may generally stop covering the drug.

Your Medicare prescription drug plan may make positive formulary changes, such as adding prescription drugs to the formulary or reducing copayments or coinsurance.

How does the cost for Medicare benefits change?

It’s unlikely that any Congress, now or in the future, will slash funding for your Medicare benefits. Medicare funding is part of the government’s mandatory spending, which means it is governed by written law and not normally by annual appropriation acts.

The premiums and deductibles for Medicare Part A and Part B can increase, but usually not by a lot.

For example, in 2019 the standard Medicare Part B premium was $135.50 a month, and in 2020 it’s $144.60 a month.

The Medicare Part B deductible increased to $198 in 2020 from $185 in 2019.

If you get your Medicare coverage through a Medicare Advantage plan, you may actually see your premiums go down year over year. For example, the average Medicare Advantage premium is estimated to be 23% lower in 2020 than in 2019, according to the Centers for Medicare and Medicaid Services (CMS).

To find a Medicare Advantage plan or Medicare Part D that may meet your needs, enter your zip code on this page.

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