Medicare Part B Premium and Deductible 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. Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act.
The 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm. Lower-than-projected spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund, which can be used to limit future Part B premium increases. The decrease in the 2023 Part B premium aligns with the CMS recommendation in a May 2022 report that excess SMI reserves be passed along to people with Medicare Part B coverage. Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10. Medicare Open Enrollment and Medicare Savings Programs Medicare Open Enrollment for 2023 will begin on October 15, 2022 and ends on December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options between Original Medicare, and Medicare Advantage, and Part D prescription drug plans. In addition to the soon-to-be released premiums and cost sharing information for 2023 Medicare Advantage and Part D plans, the Fee-for-Service Medicare premiums and cost sharing information released today will enable people with Medicare to understand their Medicare coverage options for the year ahead. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs. To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs. Medicare Part B Income-Related Monthly Adjustment Amounts Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. Medicare Part A Premium and Deductible Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,600 in 2023, an increase of $44 from $1,556 in 2022. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2023, beneficiaries must pay a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization ($389 in 2022) in a benefit period and $800 per day for lifetime reserve days ($778 in 2022). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200.00 in 2023 ($194.50 in 2022). ![]() |
Medicare Blog | Medicare News | Medicare Information
2023 Medicare Parts A & B Premiums and Deductibles
Posted by www.psmbrokerage.com Admin on Thu, Sep 29, 2022 @ 10:13 AM
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Tags: Medicare Part A, Medicare Part B, 2023
2022 Medicare Parts A & B Premiums and Deductibles
Posted by www.psmbrokerage.com Admin on Mon, Nov 15, 2021 @ 03:19 PM
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Medicare Part B Premium and Deductible 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. Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act.
The increases in the 2022 Medicare Part B premium and deductible are due to:
Medicare Open Enrollment and Medicare Savings Programs Medicare Open Enrollment for 2022 began on October 15, 2021, and ends on December 7, 2021. During this time, people eligible for Medicare can compare 2022 coverage options between Original Medicare, and Medicare Advantage, and Part D prescription drug plans. In addition to the recently released premiums and cost sharing information for 2022 Medicare Advantage and Part D plans, the Fee-for-Service Medicare premiums and cost sharing information released today will enable people with Medicare to understand all their Medicare coverage options for the year ahead. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs. To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs. Medicare Part B Income-Related Monthly Adjustment Amounts Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. The 2022 Part B total premiums for high-income beneficiaries are shown in the following table:
Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,556 in 2022, an increase of $72 from $1,484 in 2021. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2022, beneficiaries must pay a coinsurance amount of $389 per day for the 61st through 90th day of a hospitalization ($371 in 2021) in a benefit period and $778 per day for lifetime reserve days ($742 in 2021). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $194.50 in 2022 ($185.50 in 2021).
For more information on the 2022 Medicare Parts A and B premiums and deductibles (CMS-8077-N, CMS-8078-N, CMS-8079-N), please visit https://www.federalregister.gov/public-inspection. Medicare Part D Income-Related Monthly Adjustment Amounts Since 2011, a beneficiary’s Part D monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium. Part D premiums vary from plan to plan and roughly two-thirds are paid directly to the plan, with the remaining deducted from Social Security benefit checks. The Part D income-related monthly adjustment amounts are all deducted from Social Security benefit checks. The 2022 Part D income-related monthly adjustment amounts for high-income beneficiaries are shown in the following table:
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Tags: Medicare Part A, Medicare Part B, medicare changes, deductibles
Medicare Rights Testifies to Congress About the BENES Act
Posted by www.psmbrokerage.com Admin on Tue, Jan 21, 2020 @ 04:12 PM
Medicare Rights Testifies to Congress About the BENES Act Medicare Rights Center President Fred Riccardi recently testified at a hearing of the House Committee on Energy and Commerce, Subcommittee on Health titled “Legislation to Improve Americans’ Health Care Coverage and Outcomes.” In the testimony, Medicare Rights urged Congress to pass the bipartisan, bicameral Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (H.R. 2477) without delay. |
Tags: Medicare Part B, Medicare
Medicare Part B Premium to Rise 6.7%
Posted by www.psmbrokerage.com Admin on Thu, Nov 14, 2019 @ 02:13 PM
The CMS announced it will increase Medicare Part B premiums about 6.7% for most enrollees in 2020. The 2020 increase is up from an increase of 1.1% in 2019, and up from no increase in 2018. The annual Part B deductible will increase by 7%, to $198. The Social Security Administration recently announced the 2020 Social Security COLA will be 1.6%. That means the size of the 2020 COLA will be much smaller than the 2020 increase in Part B premiums.
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Tags: Medicare Part A, Medicare Part B, Medicare, deductibles, 2020
Medicare Enrollment Periods for Part B
Posted by www.psmbrokerage.com Admin on Wed, Feb 06, 2019 @ 03:30 PM
If you accept the automatic enrollment in Medicare Part B, or if you enroll during the first three months of your initial enrollment period, your coverage will start with the month you are first eligible. If you enroll during the last four months of your initial enrollment period, your coverage will start from one to three months after you enroll. The following chart shows when your Medicare Part B becomes effective:
For more information, you may click on the link below to see a reference document found within the Social Security website: Social Security Website. Scroll down to the section on signing up for Medicare. |
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Tags: Medicare Part B, Medicare
2019 Medicare Parts A&B Premiums and Deductibles
Posted by www.psmbrokerage.com Admin on Mon, Nov 26, 2018 @ 02:19 PM
2019 Medicare Parts A&B |
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Tags: Medicare Part A, Medicare Part B, Medicare, deductibles, Coinsurance
Part B and D Premiums: 2017 and Proposed
Posted by www.psmbrokerage.com Admin on Tue, Nov 07, 2017 @ 10:50 AM
Medicare's Income-Related Premiums Under Current Law and Proposed Changes The U.S. House of Representatives is considering legislation (H.R. 3922) to extend funding for the Children’s Health Insurance Program that includes a provision to increase Medicare premiums for some higher-income beneficiaries to help offset the cost of the legislation. The Congressional Budget Office (CBO) has estimated that this provision would increase Medicare's premium revenues (and thereby reduce program spending) by $5.8 billion between 2018 and 2027. This issue brief describes current requirements with respect to Medicare's Part B and Part D income-related premiums and proposed changes under the House legislation. OVERVIEW OF CURRENT LAW RELATED TO MEDICARE PREMIUMS Today, most Medicare beneficiaries pay the standard monthly premium, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries (around 6 percent in 2015) with incomes above $85,000 for single people and $170,000 for married couples are required to pay higher premiums for Medicare Part B and Part D—ranging from 35 percent to 80 percent of program costs, depending on their incomes (Figure 1). Part B and Part D Standard Premiums Monthly premiums for most people on Medicare equal 25 percent of average per capita Part B expenditures for Part B enrollees and 25.5 percent of average per capita Part D expenditures for drug plan enrollees. In 2017, the Part B standard monthly premium is $134; for Part D, the national average monthly premium, according to CMS, is $35.63. Actual monthly premiums for stand-alone Part D drug plans vary across plans and regions from a low of $14.60 to a high of $179 in 2017. Income-Related Premiums for Part B and Part D People on Medicare with incomes above $85,000 for individuals and $170,000 for couples are required to pay higher premiums for Medicare Part B and Part D. The Part B income-related premium was established by the Medicare Modernization Act of 2003 and took effect in 2007. The Part D income-related premium was established by the Affordable Care Act (ACA) and took effect in 2011. Under these provisions, beneficiaries with higher incomes pay a larger share of Part B and Part D program costs than 25 percent, ranging from 35 percent to 80 percent of per capita costs, depending on their income The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) made changes to Medicare's income-related premiums that will affect beneficiaries with incomes above $133,500 ($267,000 for married couples) by requiring them to pay a larger share of Part B and Part D program costs beginning in 2018 (Figure 2):
The income thresholds that determine the income-related premium payments are frozen through 2019, but will increase by about 2 percent in 2020 and will be indexed after that for general price inflation. HOW MUCH ARE BENEFICIARIES CURRENTLY PAYING FOR PART B AND PART D In 2017, Part B premiums for higher-income beneficiaries range from $188 per month for individuals with annual incomes above $85,000 up to $107,000, to $429 per month for individuals with incomes above $214,000. For Part D, higher-income beneficiaries pay a monthly premium surcharge in addition to the premium for their specific Part D plan; in 2017, the monthly premium surcharge ranges from around $13 for individuals with annual income above $85,000 up to $107,000, to an additional $76 for individuals with incomes above $214,000. When combined with the national average premium amount, higher-income Part D enrollees pay between $49 and $112 per month in 2017. For beneficiaries enrolled in both Part B and Part D, the combined income-related monthly premiums range from $236 (35 percent of program costs) for single beneficiaries with incomes above $85,000 up to $107,000, to $540 (80 percent of program costs) for beneficiaries with incomes above $214,000 (Figure 3). Monthly income-related premiums for married couples who are both enrolled in Part B and Part D are twice these amounts, ranging from $473 for those with incomes up from above $170,000 up to $214,000, to $1,081 for couples with incomes above $428,000. HOW WOULD THE PROPOSED LEGISLATION CHANGE MEDICARE S INCOME-RELATED PREMIUMS? The proposed legislation would modify the income thresholds that determine which beneficiaries pay 80 percent of Part B and Part D program costs, and would create an additional category requiring certain higherincome beneficiaries to pay 100 percent of program costs, beginning in 2018 (Figure 4):
The proposal would also change the inflation adjustment applied to the highest incomerelated premium category beginning in 2027. POLICY IMPLICATIONS Increasing premiums for some beneficiaries who are already subject to income-related premiums will affect a relatively small share of the Medicare population. Part of the appeal of requiring higher-income beneficiaries to pay a greater share of Medicare costs is that these higher costs are imposed on only a relatively small share of beneficiaries who arguably have greater financial means to bear the additional expenses, thereby protecting the majority of people on Medicare with relatively modest incomes. At the same time, there is some concern that the income thresholds used to trigger the payment of higher premiums by Medicare beneficiaries ($85,000 for individuals and $170,000 for couples) are lower than the thresholds used to define higher-income people in other policy discussions. There is also concern that imposing higher premiums could discourage higher-income people from enrolling in Part B and Part D, which could further erode Medicare’s financial status in the future. Adopting the House proposal would also mean that for the first time, some beneficiaries would not receive any federal subsidy for their Medicare Part B and Part D coverage and would be required to pay these costs in full. Another concern is that the Medicare savings associated with this proposal are not dedicated to Medicare but instead used to fund other priorities. |
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Tags: Medicare Part B, Medicare Part D
[INFOGRAPHIC] 2016 Medicare Parts A & B Premiums and Deductibles Announced
Posted by Carly Callahan on Thu, Nov 12, 2015 @ 12:35 PM
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced the 2016 premiums and deductibles for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs. Lucky for you, Precision Senior Marketing has taken the time to put together the following infographic summarizing what your senior clients can expect in result from the adjustments made via the Bipartisan Budget Act singed into law by President Obama last week. P.S. Don't be too shy to share this infographic with your clients by positing it to your Facebook page :) Medicare Part B Premium and Deductible
Medicare Part A Deductible
Premiums for Medicare Advantage and MAPD plans already finalized are unaffected by this announcement. Find the original press release from CMS here! To get more information about state-by-state savings, visit the CMS website at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html .
For more information on the 2016 Medicare Parts A and B premiums and deductibles (CMS-8059-N, CMS-8060-N, and CMS-8061-N), visit: https://www.federalregister.gov/public-inspection Sources: www.cms.gov |
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Everything Your Senior Clients Need to Know About the Budget Deal
Posted by Carly Callahan on Thu, Nov 05, 2015 @ 02:52 PM
On Monday, November 2, 2015, President Obama signed into law a two-year budget deal that diverts a spike in Medicare Part B premiums, but conversely wipes out billions in potential future Social Security Disability Insurance (SSDI) program benefits for Baby Boomers. While the Bipartisan Budget Act of 2015 has certainly granted much needed relief to nearly 15 million Medicare beneficiaries by lessening premium and deductible Part B increases, its approval has triggered an undesirable response to upcoming SSDI program changes. Whether or not your clients will be negatively affected by the budget deal all comes down to one very important criterion: While the reforms within the budget deal are projected to save the SSDI program $168 billion over 75 years, seniors who rely upon implementing certain strategies to increase the amount they’ll get from SSDI will ultimately lose if they fail to rethink their retirement plans. So, what are those strategies to disappear in just six short months and how can your clients get through this? Saying “goodbye” to the “file and suspend” strategyOne strategy, commonly referred to as “file and suspend”, has meant an extra $10,000 to $60,000 in SSDI benefits for some married couples age 66 to 70. Under current law this strategy allows you to sign up for benefits at age 66, but not claim them. For four years those unclaimed benefits will grow at the rate of 8% per year through delayed retirement credits. In the meantime your spouse may immediately begin collecting half of your check starting at age 66. (Divorced persons may utilize the strategy if they were once married for 10 years and are currently single.) Restricting a restricted claim of spousal benefitsAuthor of A Social Security Owner’s Manual, Jim Blankenship, believes divorced people “will be the big losers” due to the dismissal of the “restricted application” strategy. Under current law this strategy allows you or your spouse to file just for spousal benefits at Full Retirement Age and then let his or her own retirement benefits continue to grow. The end to the lump sumSenior policy analyst Web Phillips of the National Committee to Preserve Social Security and Medicare (NCPSSM) says the end of the lump sum SSDI benefits is another “good deal that goes away” in 2016. Under current law if you are diagnosed with a terminal illness at age 68 you may collect a lump sum SSDI check for the benefits you had suspended over the past two years. Under the new law this would not be the case – you could certainly begin getting retirement checks immediately, but you sure wouldn’t get a check for those back payments. What should senior couples do regarding the change?
David Leland, a managing director of Merrill Lynch in Beverly, Massachusetts advises seniors to refrain from panicking. In the future spouses will have a choice of the larger of either their own benefit or the spousal benefit when applying for SSDI benefits. Any benefit they choose they “are stuck with”, said Leland.
While your clients may have already seen headlines disclosing relief to their Medicare Part B premium and deductible (to rise by 15% opposed to the projected 52%), it is important to inform them of the above information regarding the vanishing of strategies to SSDI benefits to come. Checking up on and reaching out to your current clients to share news of this political and economic reform could be a wonderful platform for you to display your appreciation for their business. By doing so you’re essentially dropping by to say, “Hey, Mrs. Smith! I thought of you when you read this and how it could affect your and Mr. Smith’s financials.” A.K.A. “Hey, I really care about you!”
Want to keep up-to-date with more stories like these? Give Precision Senior Marketing's Facebook page a “Like”, follow us on Twitter and request to join our LinkedIn group, titled "Senior Insurance Agents", providing a central exchange for information among insurance agents. to stay informed! :)
Sources: www.californiahealthline.com, www.forbes.com |
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The Senate voted early Friday morning to approve a two-year budget deal intended to spook years of gridlock and frequent scares of government shutdowns. President Barack Obama is expected to sign the agreement [pumpkin] patched by the White House and congressional leaders. The Bipartisan Budget Act of 2015 extends the nation's debt limit through 2017 and mummifies spending levels through September of that year to keep things under wraps. It also lifts the spirits of ghostly spending caps set in place in 2011, providing for $80 billion in sequester relief. The agreement includes long-term entitlement comebacks to the Social Security Disability Insurance (SSDI) program — the first major boo-merang to Social Security since 1983 — and frightens a spike in Medicare B premiums for millions of seniors. Once signed, 15 million older Americans will face a Part B premium increase of roughly 17 percent opposed to the projected 52 percent, easing pain in the neck for beneficiaries. It's all grave-y for “held harmless” Medicare beneficiaries, as they will not see an increase in their Medicare Part B premiums due to a provision of federal law that draws blood for premiums from Social Security benefits. The Part B deductible, which covers costs if Medicare beneficiaries are coffin and need to see a doctor, will rise to $167 rather than the $223 proposed. To cover the cost of moderating the Medicare Part B premium increase, the U.S. Treasury will lend money to the Medicare blood bank. To repay the loan, beneficiaries will pay a premium surcharge of three bones each month over about five years until 2021.
On behalf of the PSM staff, we wish everyone a safe and happy Halloween filled with unlimited amounts of candy corn and other delicious treats. In the case that you over-indulge on sweets, have no fear: We've got the perfect dental and vision product for you with no waiting periods on all services!
Original sources:
Sources: www.nbcnews.com, www.washingtonpost.com |
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Tags: Congress, Medicare Part B, Premium Increases