The Centers for Medicare and Medicaid has announced the Medicare premiums, deductibles, and coinsurances for 2016. As expected, for the third year in a row the standard Medicare Part B premium that most recipients pay will hold steady at $104.90 a month. However, about 30 percent of beneficiaries will see their Part B premium rise to $121.80 a month. Meanwhile, the Part B deductible will increase for all beneficiaries from the current $147 to $166 in 2016.
The Part B rise was supposed to be much steeper for the 30 percent of beneficiaries who are not “held harmless” from any increase in premiums when Social Security benefits remain stagnant, as will be the case for 2016. But the premium rise was blunted by the Bipartisan Budget Act signed into law by President Obama November 2. Medicare beneficiaries who are unprotected from a premium increase include those enrolled in Medicare but who are not yet receiving Social Security, new Medicare beneficiaries, seniors earning more than $85,000 a year, and “dual eligibles” who receive both Medicare and Medicaid benefits.
For beneficiaries receiving skilled care in a nursing home, Medicare's coinsurance for days 21-100 will go up from $157.50 to $161. Medicare coverage ends after day 100. (For more on Medicare's nursing home coverage, click here.)
Here are all the new Medicare figures:
- Basic Part B premium: $104.90/month (unchanged)
- Part B premium for those not “held harmless”: $121.80
- Part B deductible: $166 (was $147)
- Part A deductible: $1,288 (was $1,260)
- Co-payment for hospital stay days 61-90: $322/day (was $315)
- Co-payment for hospital stay days 91 and beyond: $644/day (was $630)
- Skilled nursing facility co-payment, days 21-100: $161/day (was $157.50)
Higher-income beneficiaries will pay higher Part B premiums:
- Individuals with annual incomes between $85,000 and $107,000 and married couples with annual incomes between $170,000 and $214,000 will pay a monthly premium of $170.50 (was $146.90).
- Individuals with annual incomes between $107,000 and $160,000 and married couples with annual incomes between $214,000 and $320,000 will pay a monthly premium of $243.60 (was $209.80).
- Individuals with annual incomes between $160,000 and $214,000 and married couples with annual incomes between $320,000 and $428,000 will pay a monthly premium of $316.70 (was $272.70).
- Individuals with annual incomes of $214,000 or more and married couples with annual incomes of $428,000 or more will pay a monthly premium of $389.80 (was $335.70).
Rates differ for beneficiaries who are married but file a separate tax return from their spouse:
- Those with incomes between $85,000 and $129,000 will pay a monthly premium of $316.70 (was $272.70).
- Those with incomes greater than $129,000 will pay a monthly premium of $389.80 (was $335.70).
The Social Security Administration uses the income reported two years ago to determine a Part B beneficiary's premiums. So the income reported on a beneficiary's 2014 tax return is used to determine whether the beneficiary must pay a higher monthly Part B premium in 2016. Income is calculated by taking a beneficiary's adjusted gross income and adding back in some normally excluded income, such as tax-exempt interest, U.S. savings bond interest used to pay tuition, and certain income from foreign sources. This is called modified adjusted gross income (MAGI). If a beneficiary's MAGI decreased significantly in the past two years, she may request that information from more recent years be used to calculate the premium.
Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. The average Medicare Advantage premium is expected to decrease slightly, from $32.91 on average in 2015 to $32.60 in 2016.
For Medicare’s press release announcing the new figures, click here.
For Medicare's "Medicare costs at a glance," click here.
For more about Medicare, click here.