856.235.8501

MEDICAID AND MEDICARE 2015 COLA NUMBERS

by: Begley Law Group

CMS has released the Medicare and Medicaid numbers for 2015. They are as follows:

Medicaid

  • Income Cap[1] $2,199
  • Maximum Community Spouse Resource Allowance (CSRA)[2] $119,220
  • Minimum CSRA[3] $23,844
  • Maximum Minimum Monthly Maintenance Needs Allowance (MMMNA)[4] $2,980.50
  • MMMNA (July 1, 2014 until June 30, 2015)[5] $1,966.25
  • Excess Shelter Allowance (July 1, 2014 until June 30,   2015)[6] $589.88
  • Maximum Resource Limit (Individual)[7] $2,000
  • Minimum and Maximum Cap on Equity in the Home[8] $552,000 –  $828,000

Medicare

Part A

  • Medicare Co-Payment – Skilled Nursing Facility (SNF)[9] $157.50
  • Hospital Deductible[10] $1,260
  • Per day Co-Insurance – Day 61 -90[11] $315
  • Per day Co Insurance – Day 91-150[12] $630

Part A Premium (for voluntary enrollees only)

  • With 30-39 quarters of Social Security coverage[13] $234
  • With 29 or fewer quarters of Social Security coverage[14] $407

Part B

  • Medicare Part B Deductible[15]                                                          $147
  • Standard Part B Premium[16]                                                                                 $104.90

Medicare Part B – Single or Married and Filing Separate Return

Part B Income-Related Premium[17]

Beneficiaries who file an individual tax return with income:  Beneficiaries who file a joint tax return with income: Income-related monthly adjustment amount Total monthly premium amount 
 Less than or equal to $85,000  Less than or equalto $170,000 $0.00 $104.90
Greater than $85,000 and less than or equal to $107,000  Greater than $170,000 and less than or equal to $214,000 $42.00 $146.90
 Greater than $107,000 and less than or equal to $160,000  Greater than $214,000 and less than or equal to $320,000 $104.90 $209.80
Greater than $160,000 and less than or equal to $214,000  Greater than $320,000 and less than or equal to $428,000 $167.80 $272.70
Greater than $214,000 Greater than $428,000 $230.80 $335.70

 

In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at some time during the taxable year are:

 

Beneficiaries who are married but file a separate tax return from their spouse:  Income-related monthly adjustment amount Total monthly premium amount
Less than or equal to $85,000  $0.00 $104.90
Greater than $85,000 and less than or equal to $129,000  $167.80 $272.70
Greater than $129,000 $230.80 $335.70

 

 

Standard Part D Cost-Sharing for 2013[18]

  • Annual Deductible Maximum $320
  • Member Pays 25% of the Next $2,640                  25% = $660
  • Initial Benefit Period Maximum                             $2,960   ($320 + $2,640)
  • Donut Hole Threshold                                              $3,720
  • Catastrophic Coverage                                           $4,700  ($320 + $660 + $3,720)
  • Catastrophic cost-sharing:  Generic        $2.65 or 5% (whichever is greater)
  • Catastrophic cost-sharing: Brand        $6.60 or 5% (whichever is greater)

 

 

[1] 42 U.S.C. §1396a(a)(10)(A)(v); 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[2] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[3] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[4] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[5] 79 Fed. Reg. 3593 (Jan. 22, 2014).

[6] 79 Fed. Reg. 3593 (Jan. 22, 2014).

[7] 20 CFR § 416.1205(c).

[8] 42 U.S.C. §1396p(f); 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[9]Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[10] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[11] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[12] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[13] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[14] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[15] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[16] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[17] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[18] http://www.medicareadvocacy.org.