JUST IN: the Medicare Advantage maximum out-of-pocket limit for 2021 will be $7,550!
A plan’s maximum out-of-pocket limit is the most amount of money you will have to pay out-of-pocket in a year for services covered by Medicare. Since 2011, this limit has been $6,700 for Medicare Advantage plans. The maximum for both in- and out-of-network services combined was $10,000.
The new limits for 2021 are $7,550 for in-network and $11,300 for in- and out-of-network combined.
What does this mean for you?
Depending on what limit your Medicare Advantage plan sets for next year, your costs could go way up. Make sure to check into your plan’s maximum for 2021.
If you’re getting a Medicare plan for the first time, choose one with the best costs and coverage to fit your life and health needs.
What’s the reason for the change?
The reason that the limit has gone up is that beginning in January, those with kidney failure, also called End-Stage Renal Disease (ESRD) will be covered for the first time by Medicare Advantage plans. Those with kidney failure usually incur higher Medicare costs due to the need for dialysis and other consistent healthcare.
What can you do?
Check your plan’s Annual Notice of Change to see how high your out of pocket limit will be next year. Each plan can set its own individual limit. If you don’t like what you see, now may be the time to seek a new plan.
When searching in Medicare’s Plan Finder, check the “maximum you pay for health services” to compare different plans’ limits.