Medicare Premiums and Deductibles for 2014

 

11/26/2013 – On November 15, CMS released the Medicare premiums and deductibles for Medicare beneficiaries in 2014. In most cases, premiums and deductibles have decreased or stayed the same as in 2013. In addition, under the Affordable Care Act, many beneficiaries do not have to pay deductibles or co-pays for preventive services.

 

Medicare Part B – Physician & Non-Physician Services

Coverage

CMS will keep the Medicare Part B premium for 2014 at the same rate as 2013 – $104.90 a month.

 

People with Medicare who reported income on their tax returns above $85,000 (single) or ($170,000 filing jointly) for the last two years (2012 & 2013) are legally responsible to cover a larger portion of the cost of their coverage. The premium adjustments range from $146.80 to $335 a month for Medicare Part B.

 

Deductible

The Medicare Part B year deductible will also remain the same as 2013 – $147 for 2014. Beneficiaries may pay a Pro Rata Data Amount of $114.99 for the first month and $32.01 for the second month.

 

If patients do not sign up for Part B when they are first eligible or if they drop Part B and then get it later, they may have to pay a late enrollment penalty for as long as they have Medicare. The monthly premium for Part B will go up 10% for each full 12-month period that the beneficiary could have had Part B, but didn’t sign up for it

 

Coinsurance – 20%

 

Medicare Part A – Hospital and Other Facilities

Coverage

The Medicare A (which covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care) monthly premium is decreasing to $426, down from $441 in 2013. Only about 1 percent of people with Medicare pay a premium for Part A services. People do not pay a monthly Part A premium if they or their spouse have 40 or more calendar quarters of Medicare-covered employment and paid Medicare taxes while working.

 

Similar to Medicare B, beneficiaries who do not buy Part A when they are first eligible are at risk for their monthly premium to go up 10 percent and will have to pay the higher premium for twice the number of years they could have had Part A, but did not sign up.

 

Deductible

The Medicare A deductible will increase to $1,216 in 2014 up from $1,184 (2.7% increase) for each benefit period. This deductible is the cost to people with Medicare for up to 60 days of Medicare-covered inpatient services in the hospital for each benefit period. (A benefit period starts the day a patient is admitted and ends when the patient has been out of the hospital for 60 days in a row)

 

For hospital stays, beneficiaries will pay the following co-pays;

  • Days 1-60: $0 coinsurance for each benefit period ($0 in 2013)
  • Days 61-90: $304 coinsurance per day of each benefit period ($296 in 2013)
  • Days 91 and beyond: $608 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over a beneficiaries lifetime) ($592 in 2013)
  • Beyond the lifetime reserve days, patients pay all costs

 

For more information on deductibles for skilled nursing facilities, hospice care, and home health care as well as premium and deductible information on Part C and Part D, see the CMS Medicare Cost Website.

 

 

Tags: Medical Billing

Latest Tweets

    • Loading tweets...