CMS announces 2008 Part D Low Income Subsidy and related info
Via the Center for Medicare Advocacy/Elderbar Listserv:
PROGRAM UPDATES: QI PROGRAM EXTENDED AND MEDICARE PREMIUMS & DEDUCTIBLES ANNOUNCED FOR 2008
Qualified Individual (QI) Program Extended
The Congress has passed legislation that will continue the Qualified Individual (QI) program through the end of 2007. The President is expected to sign the legislation. This will assure the continued payment of Part B premiums for the approximately 1.5 million people who receive QI benefits. The Center for Medicare Advocacy is working with many other organizations for the passage of legislation, before the end of the year, which would make the QI program permanent, rather than subject to periodic sunset provisions. The QI benefit is doubly valuable to those who are eligible, as it pays the Part B premium (currently $93.50/month) and also entitles the beneficiary to the full Part D low income subsidy.
Cost-Sharing for Part A and Part B
On October 1, 2008 the Centers for Medicare & Medicaid Services (CMS) announced Part A and Part B premiums and deductibles for 2008.[1]
Hospital Deductible: $1,024 / benefit period
Hospital Coinsurance
Days 0-60: $0
Days 61-90: $256 / day
Days 91-150: $512 / day
Skilled Nursing Facility Coinsurance
Days 0-20: $0
Days 21-100: $128 / day
Part A Premium (for voluntary enrollees only)
With 30-39 quarters of Social Security coverage: $233 / month
With 29 or fewer quarters of Social Security coverage: $423 / month
Part B
Deductible: $135 / year
Standard Premium: $96.40 / month
Part B Income-Related Premium
* Individual tax return with income less than or equal to $82,000 or
Joint tax return with income less than or equal to $164,000
Income-related monthly adjustment amount: $0.00Total monthly premium amount: $96.40
* Individual with income greater than $82,000 and less than or equal to $102,000
Joint with income greater than $164,000 and less than or equal to $204,000
Income-related monthly adjustment amount: $25.80
Total monthly premium amount: $122.20
* Individual with income greater than $102,000 and less than or equal to $153,000
Joint with income greater than $204,000 and less than or equal to $306,000
Income-related monthly adjustment amount: $64.50
Total monthly premium amount: $160.90
* Individual with income greater than $153,000 and less than or equal to $205,000 or
Joint with income greater than $306,000 and less than or equal to $410,000
Income-related monthly adjustment amount: $103.30
Total monthly premium amount: $199.70
* Individual tax return with income greater than $205,000 or
Joint with income greater than $410,000
Income-related monthly adjustment amount: $142.90
Total monthly premium amount: $238.40
In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at some time during the taxable year are:
Beneficiaries who are married but file a separate tax return from their spouse:
* Income less than or equal to $82,000
Income-related monthly adjustment amount: $0.00
Total monthly premium amount: $96.40
* Income greater than $82,000 and less than or equal to $123,000
Income-related monthly adjustment amount: $103.30
Total monthly premium amount: $199.70
* Income greater than $123,000
Income-related monthly adjustment amount: $142.00
Total monthly premium amount:$238.40
Medicare Advantage Eligibility
* Must be enrolled in Medicare Parts A & B; enrollees are still in the Medicare program,
* Must continue to pay the Part B premium ($96.40 / month in 2008),
* Must live in the plan?s service area,
* Must not have end-stage renal disease (ESRD) at time of enrollment.
Standard Part D Cost-Sharing for 2008
On April 2, 2008 CMS issued information about Part D cost-sharing for 2008:[2] Base Beneficiary Premium: $27.93
Deductible: $275.00
Initial Coverage Limit: $2,510.00
Out-of-pocket Threshold: $4,050.00
Total Covered Part D Drugs to Get to Catastrophic Limit: $5,726.25 Catastrophic cost-sharing: Generic/ Preferred Drug: $2.25
Other: $5.60
Low-Income Subsidy Co-Payments (LIS)
Full Benefit Dual Eligibles w/incomes <100% Federal Poverty Level
Generic/Preferred Drugs: $1.05
Other: $3.10
Above Catastrophic Limit: $0.00
Full Benefit Duals with Incomes >100% Federal Poverty Level & Other Full-Subsidy Eligible Beneficiaries
Generic/preferred drugs: $2.25
Other: $5.60
Above Catastrophic Limit: $0.00
Partial Subsidy Eligible Beneficiaries
Deductible: $56.00
Co-insurance to ICL: 15%
Generics above catastrophic limit: $2.25
Others above catastrophic limit: $5.60
CMS has also announced the elimination of the 2008 late enrollment penalty for any beneficiary who qualifies for the low-income subsidy and who enrolls in a drug plan through December 31, 2008.