CMS Announces 2011 Medicare Premiums

CMS Announces 2011 Medicare Premiums, Coinsurance, and Deductibles

The Centers for Medicare and Medicaid Services (CMS) announced on November 4, 2010, the 2011
Medicare Part A and Part B premium, deductible, and coinsurance amounts to be paid by Medicare
beneficiaries. The standard monthly Medicare Part B premium will increase to $115.40 in 2011; however,  "hold harmless" provision in the current law will protect 73% of beneficiaries from the increase. These beneficiaries will pay the same $96.40 monthly premium they have paid since 2008. The Part B deductible will increase to $162 in 2011, up from $155 in 2010. Higher-income beneficiaries (those with incomes over $85,000 single/$170,000 married) will pay higher premiums.

The Medicare Part A deductible for 2011 will increase to $1,132, up from $1,100 in 2010. The Part A deductible is paid by the beneficiary per "spell of illness" for covered inpatient hospital services. After the first 60 days of hospitalization, the 2011 coinsurance will be $283 per day for days 61 through 90 ($275 in 2010), and $566 per day ($550 in 2010) for the 91st and later days. The daily coinsurance for the 21st through 100th day in a skilled nursing facility will be $141.50 in 2011, up from $137.50 in 2010.

Medicare Part B premium increase in 2011

Will my Medicare Part B premium increase in 2011?

Most Medicare beneficiaries will continue to pay the same $96.40 or $110.50 Part B premium amount in 2011. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium for 2011.

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ
titled: 2011 Part B Premium Amounts for Persons with Higher
Income Levels. In 2011:

New Part B beneficiaries will pay $115.40 (because they did not have the premium withheld from their Social Security benefit in the previous year).

• Beneficiaries who do not currently have the Part B premium withheld from their Social Security benefit will pay $115.40.

•  Higher-income beneficiares pay $115.40 plus an additional amount, based on the income-related monthly adjustment amount (IRMAA).

Medicare part A & part B premium and coinsurance rates

What are the Medicare premiums and coinsurance rates for 2011

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2011:

Medicare Premiums for 2011:

Part A: (Hospital Insurance) Premium

• Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.

• The Part A premium is $248.00 per month for people having 30-39 quarters of Medicare-covered
employment.

• The Part A premium is $450.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

Most beneficiaries will continue to pay the same $96.40 or $110.50 premium amount in 2011. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2011.

For additional details, see our FAQ titled: "Will my Medicare Part B premium increase in 2011?"

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: "2011 Part B Premium Amounts for Persons with Higher Income Levels".

Medicare Deductible and Coinsurance Amounts for 2010:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period  Medicare pays all covered costs except the Medicare Part A deductible (2011 = $1,132) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

• A total of $1,132 for a hospital stay of 1-60 days.
• $283 per day for days 61-90 of a hospital stay.
• $566 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
• All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

• $141.50 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

• $162.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $162.00 deductible.)

Medicare Part D premium cost - patient out of pocket expense

2012 Medicare Prescription Drug Plan (part D) Premium Cost

Part D Monthly Premium


The chart below shows your estimated prescription drug plan monthly premium based on your income. If your income is above a certain limit, you will pay an income-related monthly adjustment amount in addition to your plan premium.


If Your Yearly Income in 2010 was

File Individual Tax Return                                  File Joint Tax Return                   You pay

$85,000 or less                                      $170,000 or less                                 Your Plan Premium

above $85,001 up to $107,000           above $170,001 up to $214,000          $11.60 + Your Plan Premium

above $107,001 up to $160,000             above $214,001 up to $320,000      $29.90 + Your Plan Premium

above $160,001 up to $214,000              above $320,001 up to $428,000     $48.10 + Your Plan Premium

above $214,000                                   above $428,000                                $66.40 + Your Plan Premium

2012 Medicare Part -A (Hospital Insurance) Cost - How much beneficiary need to pay

Part A Services


Services : Blood
           
You Pay   In most cases, the hospital gets blood from a blood bank at no charge, and you won't have to pay for it or replace it. If the hospital has to buy blood for you, you must either pay the hospital costs for the first 3 units of blood you get in a calendar year or have the blood donated.

Services : Home Health Care    
You pay:

• $0 for home health care services
•  20% of the Medicare-approved amount for durable medical equipment

Services : Hospice Care               
You pay:

• $0 for hospice care
• A copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management
•  5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest)

Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).

Services : Hospital Inpatient Stay
You pay:

• $1,156 deductible per benefit period
• $0 for the first 60 days of each benefit period
• $289 per day for days 61-90 of each benefit period
• $578 per "lifetime reserve day" after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)

Services : Skilled Nursing Facility Stay
You pay:

• $0 for the first 20 days each benefit period
• $144.50 per day for days 21-100 each benefit period
• All costs for each day after day 100 in a benefit period

Note:If you're in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those noted above. Review the Evidence of Coverage from your plan.

Medicare premiums and coinsurance rates for 2010

Medicare premiums and coinsurance rates for 2010

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2010:

Medicare Premiums for 2010:

Part A: (Hospital Insurance) Premium

    *       Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
    *       The Part A premium is $254.00 per month for people having 30-39 quarters of Medicare-covered employment.
    *       The Part A premium is $461.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

Most beneficiaries will continue to pay the same $96.40 premium amount in 2010.  Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2010.  For additional details, see our FAQ titled: "Will my Medicare Part B premium increase in 2010?"

For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010, which is a 15% increase over the 2009 premium.  The Medicare Part B premium is increasing in 2010 due to possible increases in Part B costs.  If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $110.50 per month.  For additional details, see our FAQ titled: "2010 Part B Premium Amounts for Persons with Higher Income Levels".

Medicare Deductible and Coinsurance Amounts for 2010:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2010 = $1,100) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

    *       A total of $1,100 for a hospital stay of 1-60 days.
    *       $275 per day for days 61-90 of a hospital stay.
    *       $550 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
  
    *      All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

    *       $137.50 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

    *       $155.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $155.00 deductible.)


Related Links :

• Medicare reimbursement rates increase

• Medicare reimbursement rates for GI

• What is hospital medicare reimbursement

• How much i need to pay for medicare

2010 MEDICARE PART B Premium REIMBURSEMENTS

2010 MEDICARE PART B REIMBURSEMENTS

The County reimburses members for the full amount of their Medicare Part B premiums (standard rate) on a tax-fee basis, provided they meet certain eligibility requirements.

On December 15, 2009, the Board of Supervisors approved the 2010 Medicare Part B Premium Reimbursement Program for LACERA-administered Medicare Plan enrollees.

For most Medicare enrollees, the $96.40 Part B reimbursement rate (standard rate) in 2010 remains unchanged from 2009.

However, according to Medicare law, new Medicare enrollees in 2010 and those who meet certain higher income levels are subject to an additional income-related premium amount. These individuals are eligible for a $110.50 premium reimbursement.*

The following standard rate reimbursements are effective with the December 31, 2009 pay period for January 2010 coverage:

PART B PREMIUM DETERMINING FACTORS	MONTHLY COUNTY REIMBURSEMENT AMOUNT FOR 2010
You had $96.40 deducted from your monthly Social Security check in 2009, AND	$96.40 (standard rate)
You are not required to pay a higher Part B premium, based on your income level (often referred to as “means-testing”)
You reach age 65 and become Medicare-eligible in 2010, OR	$110.50 (standard rate)Attention: You must submit your 2010 Social Security notice to LACERA verifying your $110.50 Part B premium
Part B Medicare premium is not deducted from your monthly Social Security retirement benefit, OR
You are required to pay a $110.50 monthly Part B premium, based on income level (often referred to as “means-testing”)

*Medicare enrollees who file an individual (or married and filing separately) tax return showing a modified adjusted gross income greater than $85,000 (or $170,000 for a joint tax return) are subject to the income-related monthly adjustment amount.