Medicare Deductible

Update: As of Oct 27, 2011 the medicare deductibles and premiums for 2012 have been posted on the cmc.gov site. You can read about 2012 medicare deductibles below and find medicare advantage plans too.

Once of the questions that always seems to come up is: What is my medicare deductible for 2012? That is a good question that needs answering.  Below are the Medicare premiums and coinsurance rates for 2012. Figures are taken from Medicare.gov. Get covered with medicare advantage plans 2012.

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2012:

Medicare Premiums 2012:

Part A: (Hospital Insurance) Premium

Part B: (Medical Insurance) Premium

Most beneficiaries will see a slight increase to a $99.90 premium amount in 2012. The 2012 premium represents a $3.50 increase for most medicare beneficiares. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2012 and will also have a premium of $99.90. 

As required in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, beginning in 2007 the Part B premium a beneficiary pays each month is based on his or her annual income.  Specifically, if a beneficiary’s “modified adjusted gross income” is greater than the legislated threshold amounts ($85,000 in 2012 for a beneficiary filing an individual income tax return or married and filing a separate return, and $170,000 for a beneficiary filing a joint tax return) the beneficiary is responsible for a larger portion of the estimated total cost of Part B benefit coverage.

Medicare Deductible for 2012

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2012 = $1,156) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

• A total of $1,156 for a hospital stay of 1-60 days.
• $289 per day for days 61-90 of a hospital stay.
• $566 per day for days 91 and beyond of a hospital stay (Lifetime Reserve Days).
• For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $144.50 in 2012, compared to $141.50 in 2011.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

As a result of the Medicare Modernization Act, the Part B deductible was increased to $110 in 2005 and is indexed thereafter by the annual percentage increase in the Part B actuarial rate for aged beneficiaries.  In 2012, the Part B deductible will be $140, a decrease of $22 from 2011.  (The actuarial rate is set by law at one-half of the total estimated per-enrollee cost of Part B benefits and administrative expenses, adjusted as necessary to maintain an adequate contingency reserve.)

Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. On average Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment will increase.

For more details see the 2012 medicare fact sheet.

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