The Department of Health and Human Services' Centers for Medicare and Medicaid Services (CMS) announced the cost-of-living adjusted figures for Medicare Part A and Part B for 2010. Updated amounts for the Medicare Part D standard prescription drug benefit for 2010 have been provided as a convenience as well.
PART A DEDUCTIBLES, PREMIUMS, AND PAYROLL TAX
Medicare Part A (hospital insurance):
Deductibles:
- for inpatient hospital care (applicable to individuals enrolled in the original fee-for-service Medicare program): $1,100
- for hospital stays longer than 60-days: $275 per day
- for hospital stays longer than 90-days (lifetime reserve days): $550
- for extended care services in a skilled nursing facility: $137.50 per day for the 21st through 100th day in a benefit period
Premiums:
- full monthly Part A premium: $461 per month (for individuals with less than 30 quarters of Medicare-covered employment and for disabled individuals under age 65 who lost disability benefits because of work and earnings)
- reduced premium: $254 (persons under age 65 with disabilities who lost their disability benefits due to earning above a threshold amount AND seniors with 30 to 39 quarters of Medicare-covered employment)
The Medicare Part A payroll tax remains at 1.45% (paid by employers and employees) on all wages.
PART B DEDUCTIBLE AND PREMIUMS
Medicare Part B (supplement medical insurance covering physician and outpatient services as well as durable medical equipment):
Deductibles:
Premiums: Based on beneficiaries' income levels, with individuals whose modified adjusted gross incomes (AGIs) exceed a threshold level being subject to higher premium amounts. Higher income beneficiaries pay total premiums ranging from 35% to 80% of the value of Part B
|
Individual Income in 2008 |
Joint Income in 2008 |
2010 Part B Premium |
| $85,000 or less |
$170,000 or less |
$110.50 |
| $85,001 - $107,000 |
$170,001 - $214,000 |
$154.70 |
| $107,001 - $160,000 |
$214,001 - $320,000 |
$221.00 |
| $160,001 - $214,000 |
$320,001 - $428,000 |
$287.30 |
| Above $214,000 |
Above $428,000 |
$353.60 |
Part D Standard Benefit (drug benefit):
| Part D Standard Benefit |
2010 |
2009 |
| Deductible |
$310 |
$295 |
|
Initial Coverage Limit |
25% after deductible, up to a coverage limit of $2,830 |
25% after deductible, up to a coverage limit of $2,700 |
| Gap Amount ("Donut Hole") |
Between $2,830 and $6,440 |
Between $2,700 and $6,153.75 |
| Maximum Out-of-Pocket Threshold |
$4,550 |
$4,350 |
|
Maximum Copay in Catastrophic Coverage Portion of Benefit* |
- Generic/Preferred Multisource Drugs: $2.50
- Other Drugs: $6.30
|
- Generic/Preferred Multisource Drugs: $2.40
- Other Drugs: $6.00
|
| Retiree Drug Subsidy Amounts |
- Cost Threshold: $310
- Cost Limit: $6,300
|
- Cost Threshold: $295
- Cost Limit: $6,000
|
| National Monthly Average Premium |
$31.94 |
$30.36 |
*Beneficiary pays the greater of either 5% or the minimum copy when the catastrophic coverage limit is reached (after the gap amount)
NOTE:
- In May, the legislature enacted the "Emergency Senior Citizens Relief Act" which provided a one-time payment of $250 for Social Security recipients to address the lack of a COLA under Social Security.
- Also, in September, the "Medicare premium Fairness Act" was approved. It helps offset the increase some Medicare Part B beneficiaries pay for 2010. Those affected include low-income beneficiaries whose Part B premiums are paid by Medicaid, high-income individuals who must pay income-related Part B premiums, and those who reach age 65 in 2010 and are newly enrolled in Medicare.