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Medicare deductible, coinsurance, and premium rates for 2016

The Centers for Medicare & Medicaid Services (CMS) issued the 2016 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. The 2016 deductible, coinsurance and base premium rates are:

2016 PART A – HOSPITAL INSURANCE (HI

Deductible:$1,288.00

Coinsurance: $322.00 a day for 61st-90th day $644.00 a day for 91st-150th day (lifetime reserve days) $161.00 a day for 21st-100th day (Skilled Nursing Facility coinsurance)

  • Base Premium (BP): $411.00 a month
  • BP with 10% surcharge: $452.10 a month • BP with 45% reduction: $226.00 a month (for those who have 30-39 quarters of coverage) • BP with 45% reduction and 10% surcharge: $248.60 a month 

2016 PART B – SUPPLEMENTARY MEDICAL INSURANCE (SMI)

Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.

Standard Premium: $121.80 a month

Deductible:$166.00 a year

Pro Rata Data Amount $118.86 1st month  $47.14 2nd month

Coinsurance: 20 percent

Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM9410.pdf

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