What Changes Are Coming to Medicare In 2022?
There are several Medicare changes taking place in 2022. Here is our overview of what’s coming and what you need to know for the upcoming year.
From a major increase to Medicare Part B premium to cognitive assessments, here's what you need to know about Medicare changes in 2022.
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1. Medicare Part B Premium Increase
The Medicare Part B premium increase for 2022 is one of the highest we’ve seen in a long time, raising a whopping 14.5%.
In 2021, the Part B premium is $148.50. In 2022, the Part B premium will be $170.10. That’s a $21.60 increase.
The Part B deductible is also increasing from $203 in 2021 to $233 in 2022.
If you have a high income, you pay a higher premium for Medicare coverage.
The income thresholds have also gone up. For example, if you’re married filing jointly and make more than $182,000, you’ll pay more. Previously, that threshold was $176,000, but the slight increase is to account for inflation.
2. Medicare Part A Costs Increase
Medicare Part A costs are also increasing in 2022. The deductible for Medicare Part A, which is hospital coverage, will be $1,556 in 2022. That’s a $72 increase from 2021.
Please note: If you have a Medicare Advantage plan, you do not pay the Medicare Part A deductible because they have their own deductibles. Medicare Supplements also typically do not need to worry about Part A deductibles as well, as many plans cover that cost.
The vast majority of Medicare beneficiaries do not have a Part A premium since they meet the criteria to have it covered by employment paycheck taxes. You must have 40 quarters of Medicare-covered employment, which covers most employment in the United States.
For those who do have to pay the premium, it has increased slightly to $499/month in 2022, which is a $28 increase from 2021.
For those with 30-39 quarters of Medicare-covered employment (or those who were married to someone who did), they can buy Part A at a reduced rate of $274 in 2022, a $15 increase from 2021.
3. Lower Insulin Costs Continue
Starting January 1, 2021, you were able to join a drug plan that offers extra benefits for insulin.
The Part D Senior Savings Model is available to all people with Medicare. Plans that participate offer many types of insulin at a maximum copay of $35 for a 30-day supply. This offers a savings of up to $446 per year for this life-saving medicine.
This savings model will continue until December 31, 2025. This test contributes to the modernization of the Part D benefits and better access to prescriptions for those on Medicare.
For 2022, the following pharmaceutical manufacturers have agreed to participate in the savings program:
- Eli Lilly and Company
- MannKind Corporation (new for 2022)
- Mylan Specialty L.P., a Viatris Company (new for 2022)
- Novo Nordisk, Inc. and Novo Nordisk Pharma, Inc.
- Sanofi-Aventis U.S. LLC
We are excited to see this program continue to expand.
4. Continued Telehealth and Virtual Coverage
In the last two years, Medicare has rapidly expanded their coverage of telehealth and virtual care.
In 2022, Medicare is encouraging more physicians to embrace telehealth services by paying more for telehealth visits. See their press release about it here.
Additionally, for the first time outside of the COVID-19 public health emergency (PHE), Medicare will pay for mental health visits furnished by rural health clinics and federally qualified health centers via telecommunications technology.
This will include audio-only telephone calls, expanding mental health access for rural and other vulnerable populations.
5. Continued COVID-19 Coverage
Most services and tests related to COVID-19 are covered in full by Medicare, and that is expected to continue into 2022. That includes COVID-19 antibody tests, COVID-19 lab tests, COVID-19 vaccines and COVID-19 booster shots.
Additionally, Medicare will cover monoclonal antibody treatments, although you need to meet certain criteria in order to qualify.
You can always stay up to date on COVID-19 and Medicare by visiting https://www.medicare.gov/medicare-coronavirus.
6. Cognitive Assessment Coverage
New for 2022 is Medicare’s coverage of a cognitive assessment to look for signs of dementia, including Alzheimer’s disease.
Medicare now covers a separate visit with your regular doctor or a specialist to do a full review of your cognitive function. This is important for establishing or confirming a diagnosis like dementia, including Alzheimer’s disease, and develop a care plan. You can also bring someone with you, like a spouse, friend or caregiver, to help provide information and answer questions.
Signs of cognitive impairment include:
- Trouble remembering things
- Difficulty learning new things
- Difficulty concentrating
- Struggling with managing finances
- Trouble making decisions about everyday life
Conditions like depression, anxiety and delirium can also cause confusion, so it’s important to understand why these symptoms are occurring and look for treatments to help ease symptoms where possible.
Just be aware that Medicare Part B deductible and coinsurance rates apply.
7. Bariatric Surgery Coverage
Also new for 2022 is some new coverage available for bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery. Although, patients must meet certain conditions related to morbid obesity to qualify.
8. Part D Catastrophic Coverage Threshold Increasing to $7,050
In 2022, the Part D (drug coverage) catastrophic coverage threshold will increase from $6,550 to $7,050.
Once you reach this threshold, you’re eligible for the catastrophic benefit period, where coinsurance is only 5% of the cost of the drug, or $3.95 for generic and $9.95 for brand name.
9. Aduhelm Coverage Decision
As we discussed in our previous blog post on the subject, Medicare’s Aduhelm decision is one of the most anticipated coverage announcements expected in 2022. We anticipate seeing that news released sometime in the first quarter of 2022.
When that news is announced, we’ll make sure you hear all about it through our newsletter. Not on the list yet? There’s never been a better time. Sign up for the latest in Medicare news, tips and health articles to be delivered directly to your email.
Those are the major Medicare changes to expect in 2022. If you have any questions about how these changes will affect you or your coverage, give us a call at 833-801-7999, and we’ll be happy to help you!
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