FOR IMMEDIATE RELEASE
November 10, 2015
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
2016
Medicare Parts A & B Premiums and Deductibles Announced
Today, 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.
Part B Premiums/Deductibles
As the Social Security
Administration previously announced, there will no Social Security cost of
living increase for 2016. As a result, by law, most people with Medicare Part B
will be “held harmless” from any increase in premiums in 2016 and will pay the
same monthly premium as last year, which is $104.90.
Beneficiaries not subject to the
“hold harmless” provision will pay $121.80, as calculated reflecting the
provisions of the Bipartisan Budget Act signed into law by President Obama last
week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision
are those not collecting Social Security benefits, those who will enroll in
Part B for the first time in 2016, dual eligible beneficiaries who have their
premiums paid by Medicaid, and beneficiaries who pay an additional
income-related premium. These groups account for about 30 percent of the 52
million Americans expected to be enrolled in Medicare Part B in 2016.
“Our goal is to keep Medicare Part
B premiums affordable. Thanks to the leadership of Congress and President
Obama, the premiums for 52 million Americans enrolled in Medicare Part B will
be either flat or substantially less than they otherwise would have been,” said
CMS Acting Administrator Andy Slavitt. “Affordability for Medicare enrollees is
a key goal of our work building a health care system that delivers better care
and spends health care dollars more wisely.”
Because of slow growth in medical
costs and inflation, Medicare Part B premiums were unchanged for the 2013,
2014, and 2015 calendar years. The “hold harmless” provision would have
required the approximately 30 percent of beneficiaries not held harmless in
2016 to pay an estimated base monthly Part B premium of $159.30 in part to make
up for lost contingency reserves, according to the 2015 Trustees Report.
However, the Bipartisan Budget Act of 2015 mitigated the Part B premium
increase for these beneficiaries and states, which have programs that pay some
or all of the premiums and cost-sharing for certain people who have Medicare
and limited incomes. The CMS Office of the Actuary estimates that states will
save $1.8 billion as a result of this premium mitigation.
CMS also announced that the annual
deductible for all Part B beneficiaries will be $166.00 in 2016. Premiums for
Medicare Advantage and Medicare Prescription Drug plans already finalized are
unaffected by this announcement.
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.
Since 2007, beneficiaries with
higher incomes have paid higher Part B monthly premiums. These income-related
monthly adjustment amount (IRMAA) affect fewer than 5 percent of people with
Medicare. Under the Part B section of the Bipartisan Budget Act of 2015, high
income beneficiaries will pay an additional amount. The IRMAA, additional
amounts, and total Part B premiums for high income beneficiaries for 2016 are
shown in the following table:
|
Beneficiaries who file an
individual tax return with income:
|
Beneficiaries who file a joint
tax return with income:
|
Income-related
monthly adjustment amount
|
Total
monthly premium amount
|
|
Less than or equal to $85,000
|
Less than or equal to $170,000
|
$0.00
|
$121.80
|
|
Greater than $85,000 and less
than or equal to $107,000
|
Greater than $170,000 and less
than or equal to $214,000
|
48.70
|
170.50
|
|
Greater than $107,000 and less
than or equal to $160,000
|
Greater than $214,000 and less
than or equal to $320,000
|
121.80
|
243.60
|
|
Greater than $160,000 and less
than or equal to $214,000
|
Greater than $320,000 and less
than or equal to $428,000
|
194.90
|
316.70
|
|
Greater than $214,000
|
Greater than $428,000
|
268.00
|
389.80
|
Premiums for beneficiaries who are
married and lived with their spouse at any time during the taxable year, but
file a separate return, are as follows:
|
Beneficiaries who are married and
lived with their spouse at any time during the year, but file a separate tax
return from their spouse:
|
Income-related
monthly adjustment amount
|
Total
monthly premium amount
|
|
Less than or equal to $85,000
|
$0.00
|
$121.80
|
|
Greater than $85,000 and less
than or equal to $129,000
|
194.90
|
316.70
|
|
Greater than $129,000
|
268.00
|
389.80
|
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 pay a Part A premium since they
have at least 40 quarters of Medicare-covered employment.
The Medicare Part A annual
deductible that beneficiaries pay when admitted to the hospital will be
$1,288.00 in 2016, a small increase from $1,260.00 in 2015. The Part A
deductible covers beneficiaries' share of costs for the first 60 days of
Medicare-covered inpatient hospital care in a benefit period. The daily
coinsurance amounts will be $322 for the 61st through 90th
day of hospitalization in a benefit period and $644 for lifetime reserve days.
For beneficiaries in skilled nursing facilities, the daily coinsurance for days
21 through 100 in a benefit period will be $161.00 in 2016 ($157.50 in
2015).
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 Part A. Individuals with
30-39 quarters of coverage may buy into Part A at a reduced monthly premium
rate, which will be $226.00 in 2016, a $2.00 increase from 2015. Those with
less than 30 quarters of coverage pay the full premium, which will be $411.00 a
month, a $4.00 increase from 2015.
Deductibles and Coinsurance for
2016
|
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
|
|
SNF coinsurance
|
157.50
|
161.00
|
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.
Helpful Weblinks:
Federal Register Links:
Part A CMS-8059-N (PDF)- https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29207.pdf
and on 11/16/2015 and
available online at http://federalregister.gov/a/2015-29207
8060-N PDF- https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29176.pdf
and 11/16/2015 and on
available online at http://federalregister.gov/a/2015-29176
Part B CMS-8061-N (PDF) https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29181.pdf
and on 11/16/2015 and
available online at http://federalregister.gov/a/2015-29181
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