Medicare Cost Sharing Amounts (Archive)

This section lists Medicare cost sharing amounts.

Medicare Part A.

Medicare Part B.

Medicare Part D.

2012 Cost Sharing Amounts.

2011 Cost Sharing Amounts.

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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
2012	$248	$451
2011	$248	$450
2010	$254	$461
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
2012	$1,156
2011	$1,132
2010	$1,100

Skilled Nursing Facility Coinsurance - Medicare Part A (per benefit period)
Year	Days 1 - 20 (per day)	Days 21 - 100 (per day)
2012	$0	$144.50
2011	$0	$141.50
2010	$0	$137.50

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Medicare Part B

Medicare Part B amounts vary by enrollee. The amount of the Part B premium depends upon when the enrollee first became eligible for Medicare Part B, the enrollee’s income and tax filing status. Send a SVES query to determine the amount of the Part B premium for which an enrollee is responsible.

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Medicare Part B - Other Cost Sharing Amounts

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

Deductible - Medicare Part B
Year	Annual Deductible
2012	$140
2011	$162
2010	$155

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Medicare Part D

2012 Premium Amounts

The following chart provides the Medicare Part D cost sharing amounts for enrollees for 2012 based on whether or not a client is receiving Extra Help.

2012
	Premium Cost*	Annual Deductible	Co-Insurance Cost	Coverage Gap Costs	Copayments
Standard Benefit	Varies by plan	$320	25% of drug costs between $320.01 and $2,930 Cap of $6,657.50	50% discount on Brand name drugs; 14% discount on generic drugs between $2,930 and $6,657.50	$2.60 generic drugs; $6.50 brand name drugs
Extra Help - Full Subsidy	$0**	$0	None	None	$1.10 generic drugs; $3.30 brand name drugs***
Extra Help - Partial Subsidy	Sliding scale premiums	$65	15%	None	$2.60 generic drugs; $6.50 brand name drugs
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 2012 Amounts in Excess of Medicare Part D 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 who reside in a medical institution, nursing facility or ICF/DD whose costs are paid by MA, or who receive Home and Community Based Services are exempt from copayments.

Note: Beneficiaries who have higher incomes and exceed the same thresholds that apply to the Part B premium will pay a monthly Part D income-related adjustment amount. The beneficiary will pay the monthly premium to the Plan and then pay the income-related adjustment to Medicare.

Minnesota 2012 Benchmark Amount: $36.02.

2011 Premium Amounts

The following chart provides the Medicare Part D cost sharing amounts for enrollees for 2011 based on whether or not a client is receiving Extra Help.

2011
	Premium Cost*	Annual Deductible	Co-Insurance Cost	Coverage Gap Costs	Copayments
Standard Benefit	$32.34	$310	25% of drug costs between $310.01 and $2,840 Cap of $6,447.50	50% discount on Brand name drugs; 7% discount on generic drugs between $2,840 and $6,447.50	$2.50 generic drugs, $6.30 brand name drugs
Extra Help - Full Subsidy	$0**	$0	None	None	$1.10 generic drugs; $3.30 brand name drugs***
Extra Help - Partial Subsidy	$0	$63	None	None	$2.50 generic drugs; $6.30 brand name drugs
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 2011 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/DD whose costs are paid by MA are exempt from copayments.

Note: New in 2011 - Beneficiaries who have higher incomes and exceed the same thresholds that apply to the Part B premium, will pay a monthly Part D income related adjustment amount. The beneficiary will pay the monthly premium to the Plan and then pay the income-related adjustment to Medicare.

Minnesota 2011 Benchmark Amount: $37.55.

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Chapter 22 - Standards and Guidelines	Effective: January 1, 2012
22.55ar7 - Medicare Cost Sharing Amounts (Archive)	Archived: January 1, 2013