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SHINE: Serving the Heath Insurance Needs of Everyone

Medicare Part B premiums, deductibles and coinsurance for 2018

Lorraine York Edberg headshotLorraine York-EdbergOn November 17, 2017, the Centers for Medicare and Medicaid announced the Part A and B premiums and deductibles for 2018.

These figures are based on the Social Security Cost of Living increase of 2% for 2018 which equates to $20 monthly for every $1000 received.

The standard monthly premium for Part B enrollees will be $134 monthly, the same amount it was in 2017.

In 2017, the Medicare “hold harmless” provision protected 70% of Medicare beneficiaries from increases in their Part B Premium. That protection does not allow the Part B premium to increase greater than the dollar increase in their Social Security check.

In 2018, 30% of all Part B enrollees who are not subject to the “hold harmless” provision will pay the full premium of $134 per month. An estimated 42% of all Part B enrollees are subject to the hold harmless provision in 2018, but will pay the full monthly premium of $134, because the increase in their Social Security benefit will be greater than or equal to an increase in their Part B premiums up to the full 2018 amount. Of all Part B enrollees, 28% are subject to the hold harmless provision in 2018 and will pay less than the full monthly premium of $134, because the increase in their Social Security benefit will not be large enough to cover the full Part B premium increase.

However, the hold harmless rule also does not protect high-income Medicare beneficiaries whose individual income is above $85,000 or a couple’s joint income above $170,000. These beneficiaries will pay an increased amount for their Part B and Part D, called an income-related monthly adjustment amount, also known as “IRMAA.” The Federal government bases the 2018 adjustments on the beneficiaries’ 2016 Federal Income taxes. You may request a new initial determination through Social Security if believe your IRMAA is incorrect by contacting your local Social Security office. Some other beneficiaries will be paying higher Part B premiums if they are on Medicare Part B, but not yet collecting their Social Security benefit.

The monthly Part B premium for those who are enrolled helps pay for doctors' services, x-rays and tests, outpatient hospital care, ambulance service, medical supplies, and other medical equipment. 

The 2018 Part B deductible will be $183 for all people with Medicare, the same as the annual deductible in 2017. The Part B deductible is annual; once you have incurred $183 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 $1,316 to $1,340. 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 $329 to $335 a day, and beyond the 90th day has increased from $658 to $670 a day. For beneficiaries who have a Medigap plan to supplement Medicare, often most of these costs are covered by their supplemental insurance.

The skilled nursing facility coinsurance increased from $164.50 to $167.50 for the 21st to the 100th day. Medicare 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.

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

The SHINE Program, Serving the Health Insurance Needs of Everyone… with Medicare, provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at 1-800-498-4232 or 413-773-5555 or contact your local council on aging.