Questions & Answers

In 2015 I paid a monthly premium of $104.90 for Medicare Part B. Will this stay the same in 2016?

In 2016, the standard Part B premium amount will be $121.80 (or higher depending on your income). However, most people who get Social Security benefits will continue to pay the same Part B premium amount as they paid in 2015. This is because there was NOT a cost-of-living increase for 2016 Social Security benefits.

Your Part B premium will be higher in 2016 if:

  • You enroll in Part B for the first time in 2016
  • You don’t get Social Security benefits.
  • You are directly billed for your Part B premiums
  • You have Medicare and Medicaid, and Medicaid pays your premiums (your state will pay the standard premium amount of $121.80)
  • Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above $85,000 (single) or $170,000 (married couple)

What is the difference between Part A and Part B Medicare?

Medicare Part A is Hospital Insurance and Part B is Medical Insurance. Part A covers inpatient hospital, skilled nursing facility, and some home health care while Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, and durable medical equipment. Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment. However Part A has both a deductible and coinsurance amounts.

Are there any Part A cost increases for 2016?

Yes, the deductible for in-patient hospital stays for each benefit period will increase from $1,260 to $1,288.  Also the coinsurance per day for days 61-90 will increase from $315 to $322 and for days 91 and over will increase from $630 to $644. Also, for skilled nursing facility stays the coinsurance per day of each benefit period will increase from $157.50 to $161 in 2016.

Does Part B have any other cost increases?

Remember that Part B applies to Original Medicare. Part B has an annual deductible which covers Medicare eligible physician services, outpatient hospital services, certain home health services, and durable medical equipment. The annual deductible of $147 will increase to $166 in 2016. And remember that you (and your supplemental insurer) will still have to pay 20% of the Medicare-approved amount for services after you meet the deductible.

If you have a Medicare Advantage Plan (considered Part C) instead of Original Medicare, costs vary by plan and may be either higher or lower than those in Original Medicare. However, all Medicare Advantage Plans must cover the Part B services.

What about the costs of Part D?

The amount you pay for Part D deductibles, copayments, and/or coinsurance varies by plan. If you have limited income and resources, you may qualify for Extra Help to pay for your Medicare prescription drug coverage. Getting “Extra Help” means Medicare helps pay your Medicare Prescription Drug Plan’s (Part D) monthly premium, any yearly deductible, coinsurance, and copayments.

In 2015, drug costs for most people who qualify for full Extra Help are no more than $2.65 for each generic drug and $6.60 for each brand-name covered drug. In 2016, these amounts will increase to $2.95 and $7.40 respectively. Some people with higher incomes get partial Extra Help and pay reduced monthly premiums, deductibles, and copayments. If you qualify for partial Extra Help, you will pay no more than 15% of the costs of drugs on your plan’s formulary (drug list) until you reach the out-of-pocket limit.

Read more about 2016 Medicare Part A & B Deductibles.

 

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