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2015 Medicare Costs

On October 9th, Secretary of Health and Human Services Sylvia Burwell announced the Medicare costs for 2015.

The great news is that the Medicare B premium ($104.90) and deductible ($147) will remain at the same levels for the coming year! Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and more. Since 2007, higher income individuals ( above $85,000/year for individuals, $107,000 for joint tax returns) pay higher Part B premiums, up to $335.70 (see above article for the chart detailing the different levels).

Most Americans do not pay a premium for Part A services (hospital coverage: pays for inpatient hospitalization, skilled nursing and some home healthcare) because they have sufficient quarters of employment (40+) to qualify for Part A premium-free. For those who have 30-39 quarters of employment, the Part A premium in 2015 is $224 (down $10 from this year) and for those with 0-39 qualifying quarters, the cost is $407 (down $19).

When a Medicare recipient is admitted to the hospital, there is a Part A deductible (costs for up to a 60 day stay), which will be $1260 in 2015 (an increase of $44 over 2014). For longer stays, beneficiaries pay an additional $315 per day for days 61 through 90 in 2015, and $630 per day for hospital stays beyond the 90th day (up to 60 additional “lifetime reserve days” available; then recipient pays all costs).

Medicare Part A also covers limited skilled nursing/inpatient rehabilitation coverage*. If recipients qualify for coverage, they will owe a co-pay for days 21-100, which is $157.50 in 2015 (up from $152). For many Medicare recipients, this co-pay is covered via supplemental insurance.

*Skilled nursing facility coverage is based on meeting criteria (medical necessity for skilled inpatient rehabilitation/care and services are reasonable and necessary for your condition/prognosis). You do not automatically get a full 100 days and for many conditions; less time is very likely. The SNF coverage is also dependent upon a qualifying 3-day hospital stay (observation time does not count; see link above about hospital admissions) for the related condition. 

For the full breakdown of 2015 Medicare costs, see our Medicare 2015 Fact Sheet. We also offer these in printed form for your office/clients. For information or individualized assistance with Medicare, contact us at 727-447-5845.

Don’t forget to review your Medicare D plan for 2015! Open enrollment is from October 15th-December 7th and our patient advocates are standing by to help you ensure you save money and get the best possible coverage (without the sales pitches!).

 

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