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Medicare 2012 Updates

 

For more information also see: http://www.medicare.gov/cost/

Detailed Information:

Snapshot:

 

  2011 2012
Part A (Hospital) Deductible: $1132 $1156
Part B Deductible: $162 $140
Plan F+ Deductible:  $2000 $2070

Hospital Coinsurance

  • 61-90 days
  • 91-150 days (lifetime reserve)

 

$283
$566

 

$289
$578
Skilled Nursing Facility Care Coinsurance
21-100 days		 $141.50 $144.50

Part A (Hospital) Services

Services You Pay
Blood In most cases, the hospital gets blood from a blood bank at no charge, and you won't have to pay for it or replace it. If the hospital has to buy blood for you, you must either pay the hospital costs for the first 3 units of blood you get in a calendar year or have the blood donated.
Home Health Care You pay:
  • $0 for home health care services
  • 20% of the Medicare-approved amount for durable medical equipment
Hospice Care You pay:
  • $0 for hospice care
  • A copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management
  • 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest)
Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
Hospital Inpatient Stay You pay:
  • $1,156 deductible per benefit period
  • $0 for the first 60 days of each benefit period
  • $289 per day for days 61-90 of each benefit period
  • $578 per "lifetime reserve day" after day 90 of each benefit period
    (up to a maximum of 60 days over your lifetime)
Skilled Nursing Facility Stay You pay:
  • $0 for the first 20 days each benefit period
  • $144.50 per day for days 21-100 each benefit period
  • All costs for each day after day 100 in a benefit period

Note:If you're in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those noted above. Review the Evidence of Coverage from your plan.

Part B Monthly Premium

The standard Medicare Part B monthly premium will be $99.90 in 2012, a $15.50 decrease over the 2011 premium of
$115.40. However, most Medicare beneficiaries were held harmless in 2011 and paid $96.40 per month. The 2012
premium represents a $3.50 increase for them.


Higher-income beneficiaries pay $99.90 plus an additional amount, based on the income-related monthly adjustment
amount (IRMAA).  See Chart Below.

You pay a Part B premium each month. Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

Part B Late Enrollment Penalty

+10% for each full 12-month period that you could have had Part B, but didn't sign up for it

Part-B Premium Breakdown

If Your Yearly Income in 2010 was You pay
File Individual Tax Return File Joint Tax Return  
$85,000 or less $170,000 or less $99.90
above $85,001 up to $107,000 above $170,001 up to $214,000 $139.90
above $107,001 up to $160,000 above $214,001 up to $320,000 $199.80
above $160,001 up to $214,000 above $320,001 up to $428,000 $259.70
above $214,000 above $428,000 $319.70

If you have questions about your Part B premium, contact Social Security.


Part B (MD) Services

Services You pay
Part B Deductible You pay $140 per year.
Blood In most cases, the provider gets blood from a blood bank at no charge, and you won't have to pay for it or replace it.
However, you will pay a copayment for the blood processing and handling services for every unit of blood you get, and the Part B deductible applies.
If the provider has to buy blood for you, you must either pay the provider costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.
You pay a copayment for additional units of blood you get as an outpatient (after the first 3), and the Part B deductible applies.
Clinical Laboratory Services You pay: $0 for Medicare-approved services.
Home Health Services You pay: $0 for Medicare-approved services. You pay 20% of the Medicare-approved amount for durable medical equipment.
Medical and Other Services You pay: 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy*, and durable medical equipment.
Mental Health Services You pay: 40% of the Medicare-approved amount for most outpatient mental health care.
Other Covered Services You pay: copayment or coinsurance amounts.
Outpatient Hospital Services You pay: a coinsurance (for doctor services) or a copayment amount for most outpatient hospital services.
The copayment for a single service can't be more than the amount of the inpatient hospital deductible.

* In 2012, there may be limits on physical therapy, occupational therapy, and speech language pathology services. If so, there may be exceptions to these limits.

Note: All Medicare Advantage Plans must cover these services. Costs vary by plan and may be either higher or lower than those noted above. Review the Evidence of Coverage from your plan.

Part D (Rx) Monthly Premium

The chart below shows your estimated prescription drug plan monthly premium based on your income. If your income is above a certain limit, you will pay an income-related monthly adjustment amount in addition to your plan premium.

If Your Yearly Income in 2010 was You pay
File Individual Tax Return File Joint Tax Return  
$85,000 or less $170,000 or less Your Plan Premium
above $85,001 up to $107,000 above $170,001 up to $214,000 $11.60 + Your Plan Premium
above $107,001 up to $160,000 above $214,001 up to $320,000 $29.90 + Your Plan Premium
above $160,001 up to $214,000 above $320,001 up to $428,000 $48.10 + Your Plan Premium
above $214,000 above $428,000 $66.40 + Your Plan Premium

 

Open Enrollment Periods

 

 

Pre-Enrollment Period 10/01/2011 - 10/14/2011 During this period people with Medicare can learn about products offered during AEP (below)
Medicare Advantage Annual Election Period (AEP) Oct. 15, 2011 – Dec. 7, 2011 During this period people can enroll in a Medicare Advantage Plan for the next calendar year.  Those already enrolled in a Medicare Advantage Plan can disenroll and return to original Medicare or they can switch from one Medicare Advantage Plan to another.  People may also switch Part-D Rx. plans during this period as well.
Medicare Advantage Annual Disenrollment Period Jan. 1, 2012 – Feb. 14, 2012 Medicare Advantage Plan members may disenroll and return to original Medicare.  They can also enroll in a stand alone drug plan.