What Changes are Coming to Medicare in 2022?

Medicare Benefits Solutions
Nov 12, 2021

Fall is the time of the year when CMS announces its adjustments to Medicare insurance costs and coverage for the upcoming year. Medicare beneficiaries have a month or so to review these changes, compare available plans, and make decisions about what’s best for their healthcare needs and budgets. 

Then, during the Open Enrollment Period from October 15th to December 7th, beneficiaries can switch Medicare insurance plans based on cost and coverage differences that CMS and private insurance companies are making in the upcoming year. 

If you’re getting ready to do your Medicare coverage homework, you should be aware of what changes to expect for 2022. 

Medicare cost differences for 2022

Medicare Advantage (Part C)

Monthly premiums for Medicare Advantage plans are going down a bit. Providers have projected that monthly premiums will probably decrease from the average cost of $21.22 this year to $19.00 in 2022.

How much your Part C plan provider charges for coinsurance and other costs, depends on where you live, the plan you enroll in, and what coverage it includes.  

Prescription drug coverage (Medicare Part D)

If you have a stand-alone Part D plan, or you plan to enroll in one this year, you will probably pay the private insurance provider a bit more than last year. CMS has announced that the average monthly premium for Part D coverage will go up to $33.00 in 2022 from $31.47 in 2021. 

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Medicare coverage differences for 2022

CMS has made the following changes to Medicare insurance benefits for the new year: 

1. Cognitive assessment and care plan services

When you visit your healthcare provider in 2021 for your annual Wellness visit, you get a cognitive assessment which is done to check for signs of dementia or cognitive impairment. 

Beginning in 2022, Medicare will cover another separate visit with your primary care physician or a specialist to conduct a more thorough evaluation of your cognitive function. The aims of this visit are to establish or confirm a diagnosis of dementia like Alzheimer’s disease, and for the physician to create a care plan. 

The services provided at this visit may include:

  • Performing an examination
  • Discussing your medical history 
  • Reviewing your medications
  • Creating a plan for your care to help manage symptoms
  • Developing or updating an advance care plan
  • Referral to a specialist if applicable
  • Providing information about community resources including rehab services, adult daycare, and support groups

These services are covered by Original Medicare Part B (medical insurance). You are responsible for 20 percent of the final approved cost, as well as your Part B deductible for the year.

2. Blood-based biomarker test

Starting in 2022, Medicare will cover a blood-based biomarker test in certain cases one time every three years. 

To be eligible for this benefit, you must fulfill all of the following conditions:

  • You must be between the ages of 50 and 85.
  • You have no symptoms of colorectal disease. 
  • You have an average risk of developing colorectal cancer.

This test is categorized as a preventive screening and there is no charge if you have it done by a healthcare provider who accepts Medicare assignment.

3. COVID-19 coverage

Today Medicare covers many services related to COVID-19, and will add the following in 2022:

  • Vaccines, all doses, and boosters 
  • Diagnostic testing for COVID-19
  • Antibody tests to check for immune response
  • Monoclonal antibody treatments

All of these services have no charge for the beneficiary as of now. However, this may change in the upcoming year.

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