Medicare Cost-Sharing Amounts (Archive)

Premium - Medicare Part A

(paid monthly)

Year

People with 30-39 quarters of Medicare-covered employment

People with less than 30 quarters of Medicare-covered employment

2009

$244

$443

2008

$233

$423

Note:  Not all Medicare recipients have to pay a premium for Part A coverage.

Deductible - Medicare Part A

(per benefit period for hospital stays that are 60 days or less)

Year

Deductible Amount

2009

$1,068

2008

$1,024

Skilled Nursing Facility Coinsurance - Medicare Part A

(per benefit period)

Year

Days 1 - 20
(per day)

Days 21 - 100
(per day)

2009

$0

$133.50

2008

$0

$128

Individual Tax Return - No Spouse - Medicare Part B

Income Ranges

2009

$85,000 or less    

$85,001 - $107,000

$107,001 - $160,000

$160,001 - $213,000

$213,001 or more

$96.40

$134.90

$192.70

$250.50

$308.30

2008

$82,000 or less  

$82,000.01 - $102,000

$102,000.01 - $153,000

$153,000.01 - $205,000

$205,000.01 or more

$96.40    

$122.20

$160.90

$199.70

$238.40

Individual Tax Return - Spouse* - Medicare Part B

(*use these figures if person is filing separately from spouse or
had a spouse at least part of year)

Income Ranges

2009

$85,000 or less    

$85,001 - $128,000

$128,001 or more

$96.40

$250.50

$308.30

2008

$82,000 or less  

$82,000.01 - $123,000

$123,000.01 or more

$96.40    

$199.70

$238.40

Deductible - Medicare Part B

Year

Annual Deductible

2009

$135

2008

$135

2009

Premium Cost*

Annual Deductible

Co-Insurance Cost

Coverage Gap Costs

Copayments

Standard Benefit

Average is $28.00 per month (varies based on chosen plan)

$295 or less

25% of drug costs between $295 and $2700

Cap of $6153.75

100% of costs between the initial coverage limit based on drug costs between $2700 and $4350

5% of drug costs or less once out-of-pocket costs reach $4350

Extra Help -
Full Subsidy

$0**

$0

None

None

$1.10 - $3.20 income*** < 100% FPG

$2.40 - $6.00 income > 100% FPG for drug costs between $.01 - $6153.75

Extra Help -
Partial Subsidy

Sliding Scale Fee

$60

15% of drug costs between $60 and $6153.75

None

$2.40 generic/$6.00 brand name for drug costs exceeding $6153.75 per year

*Note: To find a Part D premium amount for a specific plan, see the Medicare web site. To find the amount of a Part D premium for which a client may be responsible, see 2008 Amounts in Excess of the Benchmark to Apply as Medical Expense.

**Note:  If enrolled in benchmark plan. If not, Extra Help pays the standard premium amount and the Medicare recipient pays premium costs in excess of the standard.

***Note:  MA enrollees residing in a medical institution, nursing facility or ICF/MR whose costs are paid by MA are exempt from copayments.

2008

Premium Cost*

Annual Deductible

Co-Insurance Cost

Coverage Gap Costs

Copayments

Standard Benefit

Average is $30.61 per month (varies based on chosen plan)

$275 or less

25% of drug costs between $275 and $2510

Cap of $5726.25

100% of costs between the initial coverage limit based on drug costs between $2510 and $4050

5% of drug costs or less once out-of-pocket costs reach $4050

Extra Help -
Full Subsidy

$0**

$0

None

None

$1.05 - $5.60 based on income***

Cap drug costs of $5726.25

Extra Help -
Partial Subsidy

Sliding Scale Fee

$56

15% of drug costs between $56 and $5726.25

None

$2.25 generic/$5.60 brand name for drug costs exceeding $5726.25 per year

*Note: To find a Part D premium amount for a specific plan, see the Medicare web site. To find the amount of a Part D premium for which a client may be responsible, see 2008 Amounts in Excess of the Benchmark to Apply as Medical Expense.

**Note:  If enrolled in benchmark plan. If not, Extra Help pays the standard premium amount and the Medicare recipient pays premium costs in excess of the standard.

***Note:  MA enrollees residing in a medical institution, nursing facility or ICF/MR whose costs are paid by MA are exempt from copayments.