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Centers for Medicare and Medicaid Services (CMS) Releases 2010 Medicare Fact Sheet and Part B Premium Increase

Steven Butler — Mon, 19 Oct 2009 04:21:39 +0000

On October 16, 2009, the Center for Medicare and Medicaid Services (CMS) released the 2010 Medicare Fact Sheet. According to CMS, the Medicare Part B monthly premium will increase to $110.50 for 2010. This is an increase of $14.10 per month (or $169.20 per year). Since there was no Cost-Of-Living Adjustment (COLA) for Social Security beneficiaries for 2010, the majority of individuals currently on Medicare will not see an increase in their monthly premium. (Federal Law includes a “hold harmless” provision that indicates that premiums will not be increased for Medicare beneficiaries receiving Social Security Benefits, if the increase from COLA does not exceed the increase in the Medicare monthly premium.)

As a result of the hold harmless provision of the Social Security Act, CMS indicated in the 2010 fact sheet that 73% of beneficiaries are protected from an increase in 2010. The Part B premium provides beneficiaries with co-insurance for doctor visits. Individuals that first enroll in Medicare Part B after November 2009 will have to pay the increased monthly premium of $110.50. The majority of beneficiaries that will be required to pay a higher premium are those that currently do not have the Part B premiums withheld from monthly Social Security payments (including individuals with low incomes whose premiums are paid through state subsidies).

Beneficiaries that file an individual tax return and have a “modified adjusted gross income” greater than $85,000 in 2010, or individuals that file a joint return and have “modified adjusted gross income” of greater than $170,000, will also be responsible for higher Medicare Part B premiums for 2010. Medicare has published a Frequently Asked Question on its’ website to help individuals with “Higher Income Levels” determine their Medicare Part B premium for 2010.

Additionally, the Medicare Part B deductible for doctor visits will be increased from the current $135 per year to $155 per year for 2010. The Medicare Part A deductible (that is paid when an individual has an inpatient hospital, skilled nursing facility, hospice or other qualified home health care service of 1-60 days) will increase to $1100 for 2010. This is an increase of $32 from the 2009 deductible. (According to my reading of 42 U.S.C.S. S 1395l, there is no “hold harmless” provision for Medicare Part A and Part B deductibles). All beneficiaries enrolled in Medicare Part D prescription drug coverage will also experience increased monthly premiums in 2010.

As indicated above, the majority of individuals that are currently receiving Medicare benefits will not see an increase in monthly Medicare Part B premiums for 2010, but will experience a net increase in Medicare costs as deductibles and Part D premiums will increase. Individuals that are currently disabled, but will not qualify for Medicare coverage until after November 2009, will not only face the increased deductibles and Part D premiums, but will also be required to pay the increased Medicare Part B premium of at least $110.50 per month when their Medicare coverage begins. Medicare has updated its’ Frequently Asked Questions to help individuals determine if their Medicare Part B premium will increase.

Although the “hold harmless” provision has protected current Medicare beneficiaries from seeing a monthly Part B premium increase in 2010, the next time Social Security payments are increased for COLA, it is likely that Medicare beneficiaries will see a much more sizable jump in their monthly premium payment. Not only will the beneficiaries have to pay the increase that occurs in that current year, they will also be responsible for any increases that had previously occurred that had not impacted them because of the “hold harmless” provision. (For example, if there is an increase of Social Security Payments because of COLA in 2011 and Medicare premiums increase to $120 per month in 2011, the individual would have their monthly Medicare Part B premium increased from $96.40 per month to $120 per month).

President Barack Obama called for Congress to quickly pass an Economic Recovery Provision for 2010 that would extend a onetime payment of $250 to all individuals receiving Social Security Retirement, Disability and Supplemental Security Income Payments. If you are currently receiving Social Security benefits and eligible for Medicare Coverage, it is important that you contact your United States Senators and United States Representative(s) to encourage them to support President Obama’s Economic Recovery Payment for 2010 so that you can qualify for a onetime payment of $250 in 2010. Delaware Residents should contact Senator Thomas Carper, Senator Edward Kaufman, and Representative Michael Castle. Passage of this legislation would help offset the increased costs that will be incurred from the Medicare deductible increases and the increase in Medicare Part D premiums outlined above.

If you are currently a client of Linarducci & Butler and have additional questions about the Medicare premium increase, please contact our office.

This article was written by Steven Butler. Steven is a partner at Linarducci & Butler, PA and his practice is limited to Social Security Disability/SSI claims. Steven offers free initial consultations for Social Security Disability/SSI claims to residents of Delaware, Maryland, New Jersey and Pennsylvania. To schedule a consultation with Steven, please use the Linarducci & Butler Contact Form or call 302-613-0707 to schedule an appointment.

Relevant Links:

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Social Security Administration Officially Announces No COLA for 2010 and Publishes 2010 Fact Sheet

Steven Butler — Fri, 16 Oct 2009 05:23:28 +0000

On October 15, 2009, the Social Security Administration officially announced that there will be no Cost-of-Living Adjustment (COLA) for Social Security Disability and Supplemental Security Income recipients for 2010. This is the first time since the Cost-of-Living Adjustment was codified by Congress in 1975 that there will not be an increase in benefits for recipients. The maximum Supplemental Security Income Benefit will remain at $674 per month in 2010.

Although there will be no COLA for 2009, increases were announced for Substantial Gainful Activity and Quarters of Coverage. Substantial Gainful Activity (SGA) for 2010 will be defined as earned income of $1,000 per month or more. Individuals that earn less than $1,000 per month can still potentially qualify for Disability Benefits despite working. Individuals that are already receiving Social Security Disability Insurance are able to work on a part-time basis as long as earned income does not exceed SGA.

In 2010, individuals must earn at least $1,120 to earn one Quarter of Coverage for Social Security purposes. To earn the maximum of 4 Quarters of Coverage for the year, an individual would need to make at least $4,480 of earned income in 2010. (Individuals must establish that they have at least 20 Quarters of Coverage in the last 10 years before becoming disabled to potentially qualify for Social Security Disability Insurance).

The Center for Medicare and Medicaid Services announced on October 16, 2009 that Medicare Part B monthly premiums will also increase in 2010.

For individuals that are enrolled in Medicare in November 2009 and December 2009, Federal Law has a “hold harmless provision” that prevents an increase to Medicare Premiums if COLA is not large enough to cover increase of Part B Premium. This means that for most individuals currently receiving Social Security Disability Insurance benefits there will be no increase in Medicare premiums as long as Medicare eligibility and enrollment began no later than November 2009. Additional information about the “hold harmless provision” of the Social Security Act can be found at the Center for Medicare Advocacy Website. (For a detailed description of the 2010 Medicare Premium and Deductible increases, please see “CMS Announces 2010 Medicare Fact Sheet and Part B Premium Increase.”)

What you can do.

If you are currently receiving Social Security benefits, it is important that you contact your United States Senators and United States Representative to encourage them to support President Obama’s Economic Recovery Payment for 2010 so that you can qualify for a onetime payment of $250 in 2010. Delaware Residents should contact Senator Thomas Carper, Senator Edward Kaufman, and Representative Michael Castle and encourage each Congressman to support the Economic Recovery Payment for 2010.

If you are currently a client of Linarducci & Butler, PA, please contact our office with additional questions.

Relevant Links:

Centers for Medicare and Medicaid Services (CMS) Releases 2010 Medicare Fact Sheet and Part B Premium Increase On October 16, 2009, the Center for Medicare and Medicaid...
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