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SHINE: Serving the Health Insurance Needs of Everyone—2022 Medicare Information

Lorraine York-Edberg, SHINE Regional Program DirectorLorraine York-Edberg, SHINE Regional Program Director2022 Medicare Part B Premiums, Deductibles, and Coinsurance

The Centers for Medicare and Medicaid (CMS) released the 2022 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs on November 12, 2021.

The standard monthly premium for Medicare Part B in 2022 will be $170.10, up from $148.50 in 2021, an increase of $21.60. This larger than usual increase is due to the rising cost of healthcare utilization combined with several other factors. This premium is normally taken out of your Social Security direct deposit. If you are not collecting Social Security yet, you will be billed the additional amount starting in 2022.

The standard monthly premium for Medicare Part B in 2022 will be $170.10, up from $148.50 in 2021, an increase of $21.60.

Social Security benefits are increasing by 5.9% in 2022, which is about $59 for every thousand dollars received from Social Security. This is the largest cost of living increase in 39 years. However, the 15.9% increase in Medicare Part B will reduce the amount of increase you receive. Medicare beneficiaries whose individual income is above $91,000 annually or a couple’s joint income that is above $182,000 annually will pay an increased amount for their Part B and Part D, called an income-related monthly adjustment amount, also known as “IRMAA.” This affects 7% of people with Medicare Part B. The federal government bases the 2022 adjustments on the beneficiaries’ 2020 federal income taxes. If you believe your IRMAA is incorrect, you may request a new initial determination by contacting your local Social Security office. This is especially important if your income has changed after 2020 due to various reasons—for instance, you have retired.

The monthly Part B premium helps pay for doctors' services, x-rays and tests, outpatient hospital care, ambulance service, medical supplies, and other medical equipment. The 2022 Part B annual deductible will be $233 for all people with Medicare, an increase of $30 from 2021. The Part B deductible is annual; once you have incurred $233 of expenses for Medicare-covered services in any year, the Part B deductible does not apply to any further (covered) services you receive for the rest of the year.

Medicare Part A (Hospital Insurance) helps pay for hospital care, skilled nursing care, home health care, hospice care, and other services. The Part A deductible will increase from $1,484 to $1,556 for beneficiaries with Medicare only, the Part A deductible is the beneficiary’s only cost for up to 60 days of Medicare-covered inpatient hospital services. The 61st to the 90th day has increased from $371 to $389 a day, and beyond the 90th day, it has increased from $742 to $778 a day. For beneficiaries who have a Medigap Supplement 1 or 1 A plan, these costs are covered by that supplemental insurance coverage.

The skilled nursing facility coinsurance increased from $185.50 to $194.50 for the 21st to the 100th day. Medicare Part A covers the first 20 days in a skilled nursing facility, after a three-day-qualifying stay in a hospital.

Many Medicare beneficiaries purchase additional insurance to cover the gaps of Medicare to help reduce out-of-pocket expenses including Medicare Supplemental Plans or Medicare Advantage Plans.

Medicare Advantage Open Enrollment Period Starts January 1, 2022

Did you know that if you are unhappy with your Medicare Advantage Plan, you have options?

The Medicare Advantage Open Enrollment Period (MA OEP) occurs each year from January 1 through March 31. You can only use this enrollment period if you have a Medicare Advantage Plan on January 1. Changes made during this period take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in February, your new coverage begins March 1. Unlike Fall Open Enrollment period, you can only make a single change during the MA OEP.

It’s important to understand and be confident in your Medicare coverage choices. If you have a Medicare Advantage Plan and want to change your plan, check out your options today. Remember, the MA OEP ends March 31.

Changes that can be made during this period include switching to:

  • a different MA plan with drug coverage;
  • a different MA plan without drug coverage;
  • Original Medicare and a Part D plan; or
  • Original Medicare without a Part D plan.

In Massachusetts you may also add Medigap coverage to your Original Medicare during this time.

People who want to leave their Medicare Advantage plan and enroll in Original Medicare, can access Medigap policies, also known as supplemental plans. We are fortunate in the state of Massachusetts, as our insurers in this state offer continuous open enrollment.

Medigap policies are health insurance policies that work with Original Medicare and pay part or all of certain remaining costs such as deductibles, coinsurance, and copayments after Original Medicare pays first.

The SHINE program, (Serving Health Information Needs of Everyone…on Medicare), provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. This is a free service, though contributions are welcome and will go a long way to help support this vital program. For further assistance with any Medicare issue, you can make a SHINE appointment. To reach a trained, certified counselor in your area, please contact the Regional Office at 800-498-4232 or 413-773-5555, or contact your local Council on Aging.

This article is based on the November 12 news release from the Centers for Medicare and Medicaid Services.