Dive Brief:
- Yesterday, CMS announced the 2016 premiums and deductibles for the Medicare physicians and outpatient hospital services (Part B) program.
- Because there will be no Social Security cost of living increase for 2016, by law, most people with Medicare Part B will be “held harmless” from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90, according to a prepared statement from CMS.
- Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week, the agency noted.
Dive Insight:
In additon to the announcement, CMS released a fact sheet on state-by-state savings.
“Our goal is to keep Medicare Part B premiums affordable. Thanks to the leadership of Congress and President Obama, the premiums for 52 million Americans enrolled in Medicare Part B will be either flat or substantially less than they otherwise would have been,” said CMS Acting Administrator Andy Slavitt in a prepared statement.
According to CMS, Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30% of the 52 million Americans expected to be enrolled in Medicare Part B in 2016.
Because of slow growth in medical costs and inflation, Medicare Part B premiums were unchanged for the 2013, 2014, and 2015 calendar years. The “hold harmless” provision would have required the approximately 30% of beneficiaries not held harmless in 2016 to pay an estimated base monthly Part B premium of $159.30 in part to make up for lost contingency reserves, according to the 2015 Trustees Report.
However, the Bipartisan Budget Act of 2015 mitigated the Part B premium increase for these beneficiaries and states, which have programs that pay some or all of the premiums and cost-sharing for certain people who have Medicare and limited incomes. The CMS Office of the Actuary estimated states will save $1.8 billion as a result of this premium mitigation.
CMS also announced that the annual deductible for all Part B beneficiaries will be $166.00 in 2016. Premiums for Medicare Advantage and Medicare Prescription Drug plans already finalized are unaffected by this announcement.
Recently, Healthcare Dive reported on the potential Medicare Part B increases and what it could mean to physicians.
The agency also released premiums and deductibles for the Medicare inpatient hospital (Part A) in the announcement. About 99% of Medicare beneficiaries do not pay a Part A premium since they have at least 40 quarters of Medicare-covered employment, CMS stated addiing, "The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288 in 2016, a small increase from $1,260 in 2015."