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.

 

Top of Page

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

 

Top of Page

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 enrolleeā€™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.

Top of Page

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

Top of Page

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.

Top of Page