856.235.8501

MEDICAID AND MEDICARE 2017 COLA NUMBERS

by: Begley Law Group

by Thomas D. Begley, Jr., Esquire, CELA

CMS has released the Medicare and Medicaid numbers for 2017. They are as follows:

Medicaid

  • Income Cap[1] $2,205
  • Maximum Community Spouse Resource Allowance (CSRA)[2] $120,900
  • Minimum CSRA[3] $24,180
  • Maximum Minimum Monthly Maintenance Needs Allowance (MMMNA)[4] $3,022.50
  • MMMNA (July 1, 2016 until June 30, 2017)[5] $2,002.50
  • MMMNA (July 1, 2017 until June 30, 2018)[6] $2,030.00
  • Excess Shelter Allowance (July 1, 2016 until June 30, 2017)[7] $600.75
  • Excess Shelter Allowance (July 1, 2017 until June 30, 2018)[8] $609.00
  • Maximum Resource Limit (Individual)[9] $2,000
  • Minimum and Maximum Cap on Equity in the Home[10] $560,000 –$840,000

Medicare

Part A

  • Medicare Co-Payment – Skilled Nursing Facility (SNF)[11] $164.50
  • Hospital Deductible[12] $1,316
  • Per day Co-Insurance – Day 61 -90[13] $329
  • Per day Co Insurance – Day 91-150[14] $658

Part A Premium (for voluntary enrollees only)

  • With 30-39 quarters of Social Security coverage[15] $227
  • With 29 or fewer quarters of Social Security coverage[16] $413

Part B

  • Medicare Part B Deductible[17] – $183
  • Standard Part B Premium[18] – $134

 

Medicare Part B – Single or Married and Filing Joint Return

Part B Income-Related Premium[19]

 

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 equal to $170,000 $0.00 $134.00
Greater thann$85,000 and less than or equal to $107,000

 

Greater than $170,000 and less than or equal to $214,000 $53.50 $187.50
Greater than $107,000 and less than or equal to $160,000

 

Greater than $214,000 and less than or equal to $320,000 $133.90 $257.90
Greater than $160,000 and less than or equal to $214,000

 

Greater than $320,000 and less than or equal to $428,000 $214.30 $348.30
Greater than $214,000 Greater than $428,000 $294.60 $428.50

 

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 $134.00
Greater than $85,000 and less than or equal to $129,000

 

$214.30 $348.30
Greater than $129,000 $294.60 $428.60

 

Standard Part D Cost-Sharing for 2017[20]

  • Annual Deductible Maximum – $400
  • Member Pays 25% of the Next… – $3,300 (25% = $825)
  • Initial Benefit Period Maximum – $3,700 ($400 + $3,300)
  • Donut Hole Threshold – $3,725

(Brand name drugs: 50% + 10% plan “subsidy,” Generic drug: 49% subsidy)

  • Catastrophic Coverage – $4,950 ($400 + $825 + $3,725)
  • Catastrophic cost-sharing:  Generic – $3.30/$8.25 or 5% (whichever is greater)
  • Catastrophic cost-sharing: Brand – $7.40 or 5% (whichever is greater)

 

 

[1] 42 U.S.C. §1396a(a)(10)(A)(v); 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[2] 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[3] 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[4] 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[5] 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[6] 82 Fed. Reg. 8832 (Jan. 31, 2017).

[7] 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[8] 82 Fed. Reg. 8832 (Jan. 31, 2017).

[9] 20 CFR § 416.1205(c).

[10] 42 U.S.C. §1396p(f); 2017 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[11] 81 Fed. Reg. 80062 (Nov 15, 2016).

[12] 81 Fed. Reg. 80062 (Nov 15, 2016).

[13] 81 Fed. Reg. 80062 (Nov 15, 2016).

[14] 81 Fed. Reg. 80062 (Nov 15, 2016).

[15] 81 Fed. Reg. 80072 (Nov 15, 2016).

[16] 81 Fed. Reg. 80071 (Nov 15, 2016).

[17] 81 Fed. Reg. 80063 (Nov 15, 2016).

[18] 81 Fed. Reg. 80063 (Nov 15, 2016).

[19] 81 Fed. Reg. 80066 (Nov 15, 2016).

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