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 – 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.
