Your Medicare Advisor
What You Can Expect to Pay for Medicare Services in 2016
By Diana Wisniewski
E
ach year there are changes to Medicare’s deductibles, co-payments and co-insurance. These amounts can either increase or decrease, though more often than not they increase. This can be problematic for seniors who are living on a tight budget. Below is a comparison chart of 2015 and 2016 Medicare charges. Some costs may be higher for individuals who
earned over $85,000/year, and for married couples who earned over $170,000/year in 2014. The chart below will focus mainly on any changes for the most used services. For a complete list of Medicare covered services and costs please visit medicare.gov or look in your 2016 Medicare & You Handbook.
Part A Services
2015
2016
Part A Premium:
If you are not eligible for premium free Part A benefits, you can purchase them for up to $407 per month.
If you are not eligible for premium free Part A benefits, you can purchase them for up to $411 per month.
$1,260 $0 $315 co-payment per day.
$1,288 $0 $322 co-payment per day.
$630 co-payment per day.
$644 co-payment per day.
$0 $157.50 co-payment per day. You pay all costs.
$0 $161 co-payment per day. You pay all costs.
Part B Services
2015
2016
Part b Premium:
Standard monthly premium is $104.90. You may pay more if you have a higher annual income as described above.
Standard monthly premium is $121.80, though most will keep last years premium of $104.90 due to no Cost of Living Adjustment. You may pay more.*
$147 20% co-insurance.
$166 20% co-insurance.
$0
$0
2015
2016
$320
$360
Coverage Gap Begins:
After total yearly drug costs reach $2,960.
After total yearly drug costs reach $3,310.
Co-Insurance during the Coverage Gap:
You pay 65% for generic drugs and 45% of brand name drugs.
You pay 58% for generic drugs and 45% of brand name drugs.
Catastrophic Coverage Begins:
After total yearly drug costs reach $4,700.
After total yearly drug costs reach $4,850.
Catastrophic Coverage Costs:
The greater of a 5% co-insurance or a $2.65 co-payment for generics and brand name drugs treated as generics, and a $6.60 co-payment for all other drugs.
The greater of a 5% co-insurance or a $2.95 co-payment for generics and brand name drugs treated as generics, and a $7.40 co-payment for all other drugs.
Inpatient Hospitalization: Deductible Days 1 - 60 Days 61 - 90 Days 91 - 150
(Lifetime Reserve Days - can only be used once)
Skilled Nursing Facility: Days 1 - 20 Days 21 - 100 Days 100 and beyond
Part B Deductible: Most Part B Covered Services: Preventive Care:
Part D - Prescription drug coverage Deductible: (aka Donut Hole)
* You may pay more if you have a higher annual income as described above, you enroll in Part B for the first time in 2016, you don’t get Social Security Benefits, you’re directly billed for Part B premiums, or you have both Medicare and Medicaid where the state will pay the standard monthly premium.