Volume 40 | Issue 154
Download this FYI as a printable PDF
The Centers for Medicare & Medicaid Services has announced the 2018 Medicare Part A and B premium, deductible, and coinsurance amounts. There is a small increase in Part A amounts, and while the standard Part B premium will not increase in 2018, some Part B enrollees protected by a “hold harmless” provision in 2017 will pay more. The Part B deductible will not increase for any beneficiaries. The 2018 Medicare Part D parameters were released earlier this year. (See our May 15, 2017 For Your Information.)
Medicare Part A
On November 17, the Centers for Medicare & Medicaid Services (CMS) announced the Medicare Part A premium, deductible and coinsurance amounts for 2018, and provided a fact sheet with additional background.
Premiums
Approximately 99% of Medicare beneficiaries do not pay a Part A premium because they have at least 40 quarters of Medicare-covered employment. For those individuals who pay a premium, the Medicare Part A premiums for the 12-month period beginning on January 1, 2018 are as follows:
| Premium Type | 2018 | 2017 | Change |
| Premium to purchase coverage for individuals who are not otherwise eligible for Medicare Part A and certain disabled individuals | $422 | $413 | 2.2% |
| Premium for certain individuals entitled to a reduced monthly premium (who had at least 30 quarters of Medicare-covered employment or were married to someone with at least 30 quarters of Medicare-covered employment) | $232 | $227 | 2.2% |
Deductible and Coinsurance Amounts
The Medicare Part A deductible and coinsurance amounts for the 12-month period beginning on January 1, 2018 are as follows:
| Deductible and Coinsurance Type | 2018 | 2017 | Change |
| Deductible for up to 60 days of Medicare-covered inpatient hospital care | $1,340 | $1,316 | 1.8% |
| Daily coinsurance for 61st through 90th day of hospitalization | $335 | $329 | 1.8% |
| Daily coinsurance for lifetime reserve days | $670 | $658 | 1.8% |
| Daily coinsurance for 21st through the 100th day of extended care services in skilled nursing facility | $167.50 | $164.50 | 1.8% |
Medicare Part B
The CMS announcement and fact sheet also included the Medicare Part B monthly premium rates and annual deductible amounts for 2018.
The standard monthly premium for Medicare Part B will not increase in 2018.
| Premium Type | 2018 | 2017 | Change |
| Standard monthly premium | $134 | $134 | 0.0% |
About 70% of Part B enrollees benefit from a “hold harmless” provision that protects them from any increase in Part B premiums (typically deducted from Social Security checks) that would effectively reduce their monthly Social Security payments. These Part B enrollees had their Part B premium capped at an average of about $109 for 2017. (See our November 30, 2016 For Your Information.) CMS estimates that for 2018, 42% of Part B enrollees will pay less than the $134 standard premium due to the hold harmless provision. The provision was triggered because the cost-of-living adjustment (COLA) for Social Security benefits in 2018 will be 2.0%, (see our October 13, 2017 For Your Information) and an increase in the Part B premium to $134 would reduce the net benefit Social Security payment for these Part B enrollees.
Who is not protected by the “hold harmless” provision?
- New Medicare enrollees in 2018
- Higher-income Medicare beneficiaries
- Medicare beneficiaries dually eligible for Medicare and Medicaid
- Medicare Part B enrollees not receiving Social Security benefits
The 30% of Social Security recipients not subject to the hold harmless provision will pay a minimum of $134 a month for Part B coverage in 2018. Medicare beneficiaries with higher incomes pay a larger portion of their Medicare Part B premium amounts based on a predetermined formula.
The 2018 Medicare Part B monthly premiums based on income tax filing status and income are:
| Individual Filing Status | Married Filing Jointly Status | 2018 Monthly Premium | 2017 Monthly Premium | Change |
| Income up to $85,000 | Income up to $170,000 | $134.00 | $134.00 | 0.0% |
| $85,001 – $107,000 | $170,001 – $214,000 | $187.50 | $187.50 | 0.0% |
| $107,001 – $133,500 | $214,001 – $267,000 | $267.90 | $267.90 | 0.0% |
| $133,501 – $160,000 | $267,001 – $320,000 | $348.30 | $267.90 | 30.0% |
| $160,001 – $214,000 | $320,001 – $428,000 | $428.60 | $348.30 | 23.1% |
| More than $214,000 | More than $428,000 | $428.60 | $428.60 | 0.0% |
Comment: The increase in the Part B premium rates for some individuals with higher incomes is a result of the Medicare Access and CHIP Reauthorization Act of 2015, which increased the amounts that higher-income enrollees must pay for coverage under Medicare Parts B and D starting in 2018. See our For Your Information from May 29, 2015.
| Married Filing Separately, Lived with Spouse During Tax Year | 2018 Monthly Premium | 2017 Monthly Premium | Change |
| Income up to $85,000 | $134.00 | $134.00 | 0.0% |
| More than $85,000 | $428.60 | $428.60 | 0.0% |
Finally, the Medicare Part B deductible for the 12-month period beginning on January 1, 2018 will remain at $183.
| Deductible Type | 2018 | 2017 | Change |
| Medicare Part B | $183 | $183 | 0.0% |