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]

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:

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.

CMS has released the Medicare and Medicaid numbers for 2015. They are as follows:

Medicaid

• Income Cap[1] $2,199
• Maximum Community Spouse Resource Allowance (CSRA)[2] $119,220
• Minimum CSRA[3] $23,844
• Maximum Minimum Monthly Maintenance Needs Allowance (MMMNA)[4] $2,980.50
• MMMNA (July 1, 2014 until June 30, 2015)[5] $1,966.25
• Excess Shelter Allowance (July 1, 2014 until June 30,   2015)[6] $589.88
• Maximum Resource Limit (Individual)[7] $2,000
• Minimum and Maximum Cap on Equity in the Home[8] $552,000 –  $828,000

Medicare

Part A

• Medicare Co-Payment – Skilled Nursing Facility (SNF)[9] $157.50
• Hospital Deductible[10] $1,260
• Per day Co-Insurance – Day 61 -90[11] $315
• Per day Co Insurance – Day 91-150[12] $630

Part A Premium (for voluntary enrollees only)

• With 30-39 quarters of Social Security coverage[13] $234
• With 29 or fewer quarters of Social Security coverage[14] $407

Part B

• Medicare Part B Deductible[15]                                                          $147
• Standard Part B Premium[16]                                                                                 $104.90

Medicare Part B – Single or Married and Filing Separate Return

Part B Income-Related Premium[17]

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:

Standard Part D Cost-Sharing for 2013[18]

• Annual Deductible Maximum $320
• Member Pays 25% of the Next $2,640                  25% = $660
• Initial Benefit Period Maximum                             $2,960   ($320 + $2,640)

• Donut Hole Threshold                                              $3,720
• Catastrophic Coverage                                           $4,700  ($320 + $660 + $3,720)

• Catastrophic cost-sharing:  Generic        $2.65 or 5% (whichever is greater)
• Catastrophic cost-sharing: Brand        $6.60 or 5% (whichever is greater)

[1] 42 U.S.C. §1396a(a)(10)(A)(v); 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[2] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[3] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[4] 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[5] 79 Fed. Reg. 3593 (Jan. 22, 2014).

[6] 79 Fed. Reg. 3593 (Jan. 22, 2014).

[7] 20 CFR § 416.1205(c).

[8] 42 U.S.C. §1396p(f); 2015 SSI and Spousal Impoverishment Standards, www.medicaid.gov.

[9]Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[10] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[11] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[12] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[13] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[14] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[15] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[16] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

[17] Medicare 2014 & 2015 Costs at a Glance, www.medicare.gov.

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