Medicare Premiums 2016

 

The Centers for Medicare and Medicaid Services (“CMS”) recently announced the 2016 annual Medicare premiums and deductibles.    

 

Medicare Part A

Medicare Part A covers in-patient hospitalizations, skilled nursing facility care and certain home health services.  The table below, from the CMS web page, provides a comparison of Part A deductibles and coinsurance for the 2015 and 2016 calendar years.  

 

Part A Deductible and Coinsurance Amounts for Calendar Years 2015 and 2016
Type of Cost Sharing 

 

2015

2016

Inpatient hospital deductible

$1,260

$1,288

Daily coinsurance for 61st-90th Day

315

322

Daily coinsurance for lifetime reserve days

630

644

Skilled nursing facility coinsurance

157.50

161.00

 

Medicare Part B

Medicare Part B covers out-patient services including physician services.  A provision in the Social Security Act, the “hold harmless” provision, protects most Medicare beneficiaries from a Part B premium increase in any year in which Social Security benefits are not subject to a cost of living increase.  Groups not protected by the hold harmless provision include high income seniors, individuals dually eligible for Medicare and Medicaid, individuals who are enrolled in Medicare but who never qualified for Social Security, and those who will enroll for Part B for the first time in 2016.      

 

Social Security benefits will not be subject to a cost of living increase in 2016, so for those protected by the hold harmless provision, the 2016 Medicare Part B premium will remain at the 2015 level or $104.90 per month at the lowest rate.  Individuals not protected by the hold-harmless provision were scheduled for a record increase in Part B premiums, however an agreement reached between the White House and Congress under the Bipartisan Budget Act of 2015, will limit the lowest Part B premium rate to $121.80 per month.  High income Medicare beneficiaries, or individuals with income greater than $85,000 will pay a higher amount based on taxable income.