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Medicare 2016 Fact Sheet

A, B and D Cost Changes

Part A Costs

Part A Monthly Premium:

  • If worked 40 or more quarters generally no Part A premium 
  • If worked less quarters there is a premium for A:
    $411 per month 0 to 29 quarters
    $226 per month 30 to 39 quarters

Hospital Stay Deductible and Costs:

  • $1,288             Deductible (for each benefit period)
  • $322 per day  For days 61 thru 90 (for each benefit period)
  • $644                For lifetime reserve days (after each 90 day benefit period, up to 60 days over your lifetime)

Skilled Nursing Facility Stay:

  • $0                     For the first 20 days each benefit period
  • $161 per day   21 to 100 days in benefit period

Part B Costs

Part B Monthly Premium:

  • $104.90: If income is under $85,000 per year single; $170,000 couple. The premium will remain $104.90, if you have collected Social Security benefits in 2015 and your Part B premium was deducted from these benefits.
  • $121.80: If you are new to Medicare Part B in 2016, if your are subject to an IRMMA (income is over $85,000 per year single, $179,000 couple), if you are enrolled in QMB and SLMB (the State will continue to pay the full Part B premium for those who meet the income and asset guidelines for these programs), and all who were enrolled in QMB or SLMB in 2015 and lost the benefit because their income rose or they failed to recertify. .

Part B Deductible:

  • The first $166 yearly.

Assistance with Medicare Part D

Extra Help:

  • 2016 Benchmark $33.45
  • (If premium is over the benchmark by $2 or less, some standard plans do not charge the difference)
  • Full Dual Eligibles – On Medicare and Medical Assistance (red and white card) Extra Help: Generic $1.20; Brand $3.60
  • Full Extra Help – (Those who quality for QMB or SLMB) Extra Help: Generic $2.95; Brand $7.40

Maryland Senior Prescription Drug Assistance program

  • Will pay up to $40 towards the monthly Medicare Part D Plan's premium     

2016 Standard Medicare D Plan:

  • A monthly premium
  • May be a deductible of no more than $360
  • Initial coverage period lasts until the total amount spent on Part D drugs totals $3,310 (includes amounts paid by plan, as well as the beneficiary,who typically pays 25 percent of retail cost for brand drugs and generics..
  • Coverage gap period known as the donut hole, beneficiary generally pays 45 percent of retail for brand drugs and 58 percent of retail for generics.
  • Catastrophic coverage period starts when total out of pocket threshold of $4,850 is reached (at this time the full cost of drugs is approximately $7/062). Within this period, brand and generic drugs will cost 5 percent of retail or less for the remainder of the calendar year.

Revised July 5, 2016        

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