2017 Parts A & B pre­mi­ums, de­ductibles set

Record Observer - - Senior Satellite -

On Nov. 10, 2016, the Cen­ters for Medi­care & Med­i­caid Ser­vices an­nounced the 2017 pre­mi­ums for the Medi­care in­pa­tient hos­pi­tal (Part A) and physi­cian and out­pa­tient hos­pi­tal ser­vices (Part B) pro­grams.

Medi­care Part B Pre­mi­ums/De­ductibles Medi­care Part B cov­ers physi­cian ser­vices, out­pa­tient hos­pi­tal ser­vices, cer­tain home health ser­vices, durable med­i­cal equip­ment, and other items.

On Oct. 18, 2016, the So­cial Se­cu­rity Ad­min­is­tra­tion an­nounced that the cost-of-liv­ing ad­just­ment for So­cial Se­cu­rity ben­e­fits will be 0.3 per­cent for 2017. Be­cause of the low So­cial Se­cu­rity COLA, a statu­tory “hold harm­less” pro­vi­sion de­signed to pro­tect se­niors, will largely pre­vent Part B pre­mi­ums from in­creas­ing for about 70 per­cent of ben­e­fi­cia­ries. Among this group, the av­er­age 2017 pre­mium will be about $109, com­pared to $104.90 for the past four years.

For the re­main­ing roughly 30 per­cent of ben­e­fi­cia­ries, the stan­dard monthly premi- um for Medi­care Part B will be $134 for 2017, a 10 per­cent in­crease from the 2016 pre­mium of $121.80. Be­cause of the “hold harm­less” pro­vi­sion cov­er­ing the other 70 per­cent of ben­e­fi­cia­ries, pre­mi­ums for the re­main­ing 30 per­cent must cover most of the in­crease in Medi­care costs for 2017 for all ben­e­fi­cia­ries. This year, as in the past, the Sec­re­tary has ex­er­cised her statu­tory au­thor­ity to mit­i­gate pro­jected pre­mium in­creases for these ben­e­fi­cia­ries, while con­tin­u­ing to main­tain a pru­dent level of re­serves to pro­tect against un­ex­pected costs. The De­part­ment of Health and Hu­man Ser­vices will work with Congress as it ex­plores bud­get-neu­tral so­lu­tions to chal­lenges cre­ated by the “hold harm­less” pro­vi­sion.

“Medi­care’s top pri­or­ity is to en­sure that ben­e­fi­cia­ries have af­ford­able ac­cess to the care they need,” said CMS Act­ing Ad­min­is­tra­tor Andy Slavitt. “We will con­tinue our ef­forts to im­prove af­ford­abil­ity, ac­cess, and qual­ity in Medi­care.”

Medi­care Part B ben­e­fi­cia­ries not sub­ject to the “hold harm­less” pro­vi­sion in­clude ben­e­fi­cia­ries who do not re­ceive So­cial Se­cu­rity ben­e­fits, those who en­roll in Part B for the first time in 2017, those who are di­rectly billed for their Part B pre­mium, those who are du­ally el­i­gi­ble for Med­i­caid and have their pre­mium paid by state Med­i­caid agen­cies, and those who pay an in­come-re­lated pre­mium. These groups rep­re­sent ap­prox­i­mately 30 per­cent of to­tal Part B ben­e­fi­cia­ries.

CMS also an­nounced that the annual de­ductible for all Medi­care Part B ben­e­fi­cia­ries will be $183 in 2017 (com­pared to $166 in 2016). Pre­mi­ums and de­ductibles for Medi­care Ad­van­tage and pre­scrip­tion drug plans are al­ready fi­nal­ized and are un­af­fected by this an­nounce­ment.

Since 2007, ben­e­fi­cia­ries with higher in­comes have paid higher Medi­care Part B monthly pre­mi­ums. These in­come-re­lated monthly pre- mium rates af­fect roughly 5 per­cent of peo­ple with Medi­care

Medi­care Part A Pre­mi­ums/De­ductibles Medi­care Part A cov­ers in­pa­tient hos­pi­tal, skilled nurs­ing fa­cil­ity, 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 when ad­mit­ted to the hos­pi­tal will be $1,316 per ben­e­fit pe­riod in 2017, an in­crease of $28 from $1,288 in 2016. The Part A de­ductible cov­ers ben­e­fi­cia­ries’ share of costs for the first 60 days of Medi­care-cov­ered in­pa­tient hos­pi­tal care in a ben­e­fit pe­riod. Ben­e­fi­cia­ries must pay a coin­sur­ance amount of $329 per day for the 61st through 90th day of hos­pi­tal­iza­tion ($322 in 2016) in a ben­e­fit pe­riod and $658 per day for life­time re­serve days ($644 in in 2016). For ben­e­fi­cia­ries in skilled nurs­ing fa­cil­i­ties, the daily coin­sur­ance for days 21 through 100 of ex­tended care ser­vices in a ben­e­fit pe­riod will be $164.50 in 2017 ($161 in 2016).

En­rollees age 65 and over who have fewer than 40 quar­ters of cov­er­age and cer­tain per­sons with dis­abil­i­ties pay a monthly pre­mium in or­der to re­ceive cov­er­age un­der Medi­care Part A. In­di­vid­u­als who had at least 30 quar­ters of cov­er­age or were mar­ried to some­one with at least 30 quar­ters of cov­er­age may buy into Part A at a re­duced monthly pre­mium rate, which will be $227 in 2017, a $1 in­crease from 2016. Unin­sured aged and cer­tain in­di­vid­u­als with dis­abil­i­ties who have ex­hausted other en­ti­tle­ment and who have less than 30 quar­ters of cov­er­age will pay the full pre­mium, which will be $413 a month, a $2 in­crease from 2016.

Mike Zim­mer is Pres­i­dent of Bay State In­sur­ance Agency Ltd. in Cen­tre­ville. He is avail­able to an­swer your ques­tions or speak to your groups re­gard­ing Medi­care, Medi­care Ad­van­tage, Medi­care Sup­ple­ments and Medi­care Part D (pre­scrip­tion plans). He may be reached at 410-758-1680.


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