Medicare Cost-Sharing Amounts (Archive)

This section lists Medicare cost-sharing amounts.

Medicare Part A

The following charts provide the Medicare Part A cost-sharing amounts.

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
2010	$254	$461
2009	$244	$443
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
2010	$1,100
2009	$1,068

Skilled Nursing Facility Coinsurance - Medicare Part A (per benefit period)
Year	Days 1 - 20 (per day)	Days 21 - 100 (per day)
2010	$0	$137.50
2009	$0	$133.50

Medicare Part B

Medicare Part B Beneficiaries Who File an Individual Tax Return (Not Married)
Income Ranges
2010	$85,000 or less	$85,001 - $107,000	$107,001 - $160,000	$160,001 - $214,000	$214,001 or more
	$110.50*	$154.70	$221.00	$287.30	$353.60
	*Clients who received Medicare Part B in 2009, had income at or below $85,000, and had their premiums withheld from their Social Security or Railroad Retirement will continue to pay premiums based on the base rate of $96.40 in 2010.
2009	$85,000 or less	$85,001 - $107,000	$107,001 - $160,000	$160,001 - $213,000	$213,001 or more
2009	$96.40	$134.90	$192.70	$250.50	$308.30

Medicare Part B Beneficiaries Who File an Individual Tax Return (Married) (use these figures if person is filing separately from spouse and lived with the spouse at any time during the year)
Income Ranges
2010	$85,000 or less	$85,001 - $129,000	$129,001 or more
	$110.50*	$287.30	$353.60
	*Clients who received Medicare Part B in 2009, had income at or below $85,000, and had their premiums withheld from their Social Security or Railroad Retirement will continue to pay premiums based on the base rate of $96.40 in 2010.
2009	$85,000 or less	$85,001 - $128,000	$128,001 or more
2009	$96.40	$250.50	$308.30

Medicare Part B Beneficiaries Who File a Joint Tax Return
Income Ranges
2010	$170,000 or less	$170,001 - $214,000	$214,001 - $320,000	$320,001 - $428,000	$428,001 or more
	$110.50*	$154.70	$221.00	$287.30	$353.60
	*Couples who received Medicare Part B in 2009, had income at or below $170,000, and had their premiums withheld from their Social Security or Railroad Retirement will continue to pay premiums based on the base rate of $96.40 in 2010.

Medicare Part B - Other Cost-Sharing Amounts

The following chart provides the Medicare Part B deductible amounts for each year.

Medicare Part D

2010 Premium Amounts

The following chart provides the Medicare Part D cost-sharing amounts for enrollees for 2010 based on whether a client is receiving Extra Help.

2010
	Premium Cost*	Annual Deductible	Co-Insurance Cost	Coverage Gap Costs	Copayments
Standard Benefit	Average is $37.55 per month (varies based on chosen plan)	$310 or less	25% of drug costs between $310 and $2,830 Cap of $6,440	100% of costs between the initial coverage limit based on drug costs between $2,830 and $4,550	5% of drug costs or less once out-of-pocket costs reach $4,550
Extra Help - Full Subsidy	$0**	$0	None	None	$1.10 - $3.30 income*** < 100% FPG $2.50 - $6.30 income > 100% FPG for drug costs between $.01 - $6,440
Extra Help - Partial Subsidy	Sliding Scale Fee	$63	15% of drug costs between $63 and $6,440	None	$2.50 generic/$6.30 brand name for drug costs exceeding $6,440 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 2010 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.

2009 Premium Amounts

The following chart provides the Medicare Part D cost-sharing amounts for the enrollee for 2009 based on whether a client is receiving Extra Help.

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 $2,700 Cap of $6,153.75	100% of costs between the initial coverage limit based on drug costs between $2,700 and $4,350	5% of drug costs or less once out-of-pocket costs reach $4,350
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 - $6,153.75
Extra Help - Partial Subsidy	Sliding Scale Fee	$60	15% of drug costs between $60 and $6,153.75	None	$2.40 generic/$6.00 brand name for drug costs exceeding $6,153.75 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 2009 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.

Chapter 22 - Standards and Guidelines	Effective: December 1, 2009
22.55ar4 - Medicare Cost-Sharing Amounts (Archive)	Archived: April 1, 2010