In Elder Law News

Medicare premium to edge up in 2019After staying the same last year, Medicare’s Part B premium will increase slightly in 2019. The premium will increase $1.50 from $134 a month to $135.50.

Some Medicare recipients have been paying a lower premium because they are protected by something called the “hold harmless” rule from any increase in premiums when Social Security benefits don’t rise. Due to increases in Social Security in 2018 and 2019, recipients who were previously shielded by this provision and paying lower premiums may see their premiums increase to the full $135.50 amount. In 2019, only an estimated 2 million Medicare beneficiaries (about 3.5 percent) will pay less than the full Part B standard monthly premium amount.

The Part B deductible will increase from $183 to $185 in 2019, while the Part A deductible will go up by $24, to $1,364. For beneficiaries receiving skilled care in a nursing home, Medicare’s coinsurance for days 21-100 will inch up from $167.50 to $170.50. Medicare coverage ends after day 100. (For more on Medicare’s nursing home coverage, click here.)

Here are all the new Medicare payment figures:

  • Part B premium: $135.50 (was $134)
  • Part B deductible: $185 (was $183)
  • Part A deductible: $1,364 (was $1,340)
  • Co-payment for hospital stay days 61-90: $341/day (was $335)
  • Co-payment for hospital stay days 91 and beyond: $682/day (was $670)
  • Skilled nursing facility co-payment, days 21-100: $170.50/day (was $167.50)

So-called “Medigap” policies can cover some of these costs. For more on these policies, click here.

Premiums for higher-income beneficiaries ($85,000 and above) are as follows:

  • 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 $189.60.
  • Individuals with annual incomes between $107,000 and $133,500 and married couples with annual incomes between $214,000 and $267,000 will pay a monthly premium of $270.90.
  • Individuals with annual incomes between $133,500 and $160,000 and married couples with annual incomes between $267,000 and $320,000 will pay a monthly premium of $352.20.
  • Individuals with annual incomes above $160,000 and less than $500,000 and married couples with annual incomes above $320,000 and less than $750,000 will pay a monthly premium of $433.40.
  • Individuals with annual incomes above $500,000 and married couples with annual incomes above $750,000 will pay a monthly premium of $460.50

Rates differ for beneficiaries who are married but file a separate tax return from their spouse. Those with incomes greater than $85,000 and less than $415,000 will pay a monthly premium of $433.40. Those with incomes greater than $415,000 will pay a monthly premium of $460.50.

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 2016 tax return is used to determine whether the beneficiary must pay a higher monthly Part B premium in 2018. 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. You can also request to reverse a surcharge if your income changes.

Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. CMS estimates that the Medicare Advantage average monthly premium will decrease by 6 percent in 2019, from an average of $30 in 2018 to $28 in 2019.

For Medicare’s press release announcing the new premium and deductible amounts, click here.

For more about Medicare, click here.

 

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