December 2, 2016

Medicare Premium, Coinsurance, Deductible, and Therapy Caps Update for 2017

By Melissa Korey, Supervisor, Advisory Services

Related Industry Healthcare

Medicare Premium, Coinsurance, Deductible, and Therapy Caps Update for 2017

The Centers for Medicare and Medicaid Services (“CMS”) just released the new Medicare premium, coinsurance, and deductible rates for 2017.

For in-patient hospital services furnished in calendar year (“CY”) 2017, the deductible amount is $1,316 (an increase of $28 from 2016). The deductible covers all of a beneficiary’s costs during days 1-60 of a Medicare-covered in-patient hospital stay. The daily coinsurance rates for in-patient hospital stays beyond day 60 through day 90 will be $329. If a beneficiary utilizes hospital lifetime reserve days during 2017, the coinsurance amount per day will be $658.

For skilled nursing facility services furnished in calendar year 2017, the daily coinsurance rate for Medicare days 21 through 100 will be $164.50. This is an increase of $3.50 from 2016.

The Part B medical insurance for those who meet the “hold harmless” provision for 2017 will increase to $109, compared to $104.90 for the past four years. The Part B deductible also increased to $183 for 2017. This is an increase of $16.

The following chart summarizes the Part B premiums for those who are subject to the income-related additional premium amounts:

Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income: Income-related monthly adjustment amount: Total monthly premium amount:
Less than or equal to $85,000 Less than or equal to $170,000 $0.00 $134.00
Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 53.50 187.50
Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 133.90 267.90
Greater than  $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000 214.30 348.30
Greater than $214,000 Greater than $428,000 294.60 428.60

Some individuals who have fewer than 40 quarters of Medicare-covered employment choose to purchase Medicare Part A benefits by paying a monthly premium. The Part A premiums for those with fewer than 30 quarters of coverage will be $413 per month, an increase of $2 from 2016. For individuals with 30 to 39 quarters of coverage, the reduced premium will be $227, a decrease of $1 from 2016.

Outpatient therapy caps for physical therapy and speech language pathology combined will see an increase from $1,960 to $1,980 for CY 2017. Occupational therapy will also see a $20 increase from last year to $1,980 for CY 2017.

If you have questions regarding Medicare premiums, coinsurance, deductibles, or therapy caps for 2017, please contact your Marcum advisor.