Greg Dill: Looking at your Medicare costs for 2018

How much will your Medicare cost in the coming year? The numbers just came out, so let’s go over them.

We’ll start with the Medicare Part B premium. Part B covers doctor services, outpatient hospital services, certain home health services, durable medical equipment, and other items.

The standard monthly premium for people with Part B will be $134 for 2018, the same amount as in 2017.

Under the law, people with Part B pay 25 percent of the costs of running the program, with the government picking up 75 percent.

A statutory “hold harmless” provision applies each year to about 70 percent of Part B enrollees. For these enrollees, any increase in Part B premiums must be lower than any cost-of-living increase in their Social Security benefits.

After several years of no or small increases, Social Security benefits will increase by 2 percent in 2018 due to a cost-of-living adjustment. Therefore, some beneficiaries who were held harmless against Part B premium increases in prior years will see a higher premium in 2018.

Part B enrollees held harmless in 2016 and 2017 will see an increase in their Part B premiums from the roughly $109, on average, they paid in 2017. An estimated 42 percent of Part B enrollees are subject to the hold harmless provision in 2018 but will pay the full premium of $134, because the increase in their Social Security benefit will be greater than or equal to an increase in their Part B premiums up to the full 2018 amount.

About 28 percent of Part B enrollees are subject to the hold harmless provision in 2018 but will pay less than the full $134 premium. That’s because the increase in their Social Security benefit isn’t big enough to cover the full Part B premium increase.

The remaining 30 percent of Part B enrollees aren’t subject to the hold harmless provision and will pay the full $134 per month in 2018. This group includes beneficiaries who don’t receive Social Security benefits; enroll in Part B for the first time in 2018; are directly billed for their Part B premium; are eligible for both Medicare and Medicaid and have their premiums paid by state Medicaid agencies; and pay higher premiums because their incomes are higher.

Since 2007, beneficiaries with higher incomes have paid higher Part B premiums. These higher premiums apply to about 5 percent of people with Part B.

For a chart showing premiums at higher income levels, go to: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-17.html.

The annual deductible for Part B will be $183 in 2018, the same amount as in 2017.

Now let’s take a look at Medicare Part A, which covers inpatient hospital care, skilled nursing services, and some home health services.

About 99 percent of Medicare beneficiaries don’t pay any Part A premium since they’ve worked for at least 40 quarters in Medicare-covered jobs.

The Part A deductible beneficiaries pay when admitted to the hospital in 2018 will be $1,340 per benefit period, a rise of $24 from 2017. The Part A deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

Beneficiaries must pay a coinsurance amount of $335 per day for the 61st through 90th day of a hospitalization (versus $329 in 2017) in a benefit period, and $670 per day for lifetime reserve days ($658 in 2017).

For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $167.50 in 2018 ($164.50 in 2017).

You can find an explanation of benefit periods (and lots of other valuable information) in the “Medicare & You” handbook, at https://www.medicare.gov/medicare-and-you/medicare-and-you.html.

Happy holidays to you and your loved ones!

Greg Dill is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).