MEDICARE CORNER
YOUR MEDICARE COSTS SHARING 2018
PART B 2018
If enrolled in a Medicare Advantage Plan (Part
C) premium and other costs sharing varies by
Plan. Compare costs for Part C Plans in your
2018 “Medicare & You” handbook, starting on
page 132.
2018 Part B Deductibles:
Part B Deductible $183
What You Will Pay in 2018 For Your Part
B and D Premium if Your Annual Income in
2016 Was:
BY FELICE HANNAH
• If you have health coverage and/or prescription
drug coverage from your Employer, Union,
COBRA, Federal Employee or Veteran Benefits,
check with your Human Resource Manager,
regarding your cost sharing and coverage.
• If you are receiving your health coverage
through a Medicare Advantage Plan (Part C),
check with the Plan regarding your cost sharing.
• If you are enrolled in the Affordable Care
Act Health Exchange Program and eligible for
Medicare Enrollment, you may be charged a
Part B Penalty if you do not enroll at the time
of eligibility.
PART A 2018
Most people do not pay a Part A Premium. The
Social Security Administration will assist you in
determining if you have “Premium Free Part A.”
2018 Part A Inpatient Deductibles and
Coinsurance Per Benefit Period:
A Benefit Period (days 1–90) begins on day
of admission to a hospital or Skilled Nursing
Facility (SNF). A new Benefit Period begins If
you have not received any skilled services as
an inpatient in a hospital or SNF for 60 days
in a row. You may have several Benefit Periods
during the year. Benefit Periods reset on January
1 of each year.
Cost Sharing during a Benefit Period:
Deductible $1,340 per Benefit Period.
Day 1–60: $0 coinsurance
Days 61–90: $335 coinsurance per day
Days 91 and up to 60 days of “lifetime reserve
days”: $670 per day
Beyond “lifetime reserve days” you pay
all costs
Skilled Nursing Facility Costs:
Note: Days spent as a hospital inpatient count
towards days in an SNF
Days 1–20: $0 coinsurance
Days 21–100: $167.50 coinsurance per day
All costs beyond days 101
2018
January PART B:
File individual tax
File married &
File joint tax return
You pay
return
separate tax return
¢COURIER $85,000or less $170,000 or less $85,000 or less $134
$85,001–$107,000 $170,001–$214,000 Not Applicable (NA) $187.50
$107,001–$133,500 $214,001–$267,000 NA $287.90
TOWERS $133,501–$160,000 $267,001–$320,000 NA $348.30
necessary, a written notice called an “Advance
Above $160,000 Above $320,000 Above $85,000 $428.60
Beneficiary Notice of Non-coverage (ABN)”
HIGHER INCOME PART D
must be given to you
Therapy Cap Limits:
SHORE File individual tax
File married &
File joint tax return
You pay
Speech and Language & Physical
return
separate tax return
Therapy—$2,010
$85,000 or less $170,000 or less $85,000 or less Plan Premium Only
Occupational Therapy—$2,010
NORTH $85,001–$107,000 $170,001–$214,000 NA $13 + Plan Premium
Threshold Limits:
Speech and Language & Physical
$107,001–$133,500 $$214,001–$287,000 NA $33 + Plan Premium
Therapy—$3,700
#133,501–$160,000 $$267,001–$320,000 NA $54.20 + Plan Premium
20 Occupational Therapy—$3,700 2018 Physical(PT)/Occupational
Therapy(OT)/Speech and Language Outpatient
Limits
• You may qualify for an exception to the
Therapy Cap Limits, if the Therapist can establish
that the services are “medically reasonable
and necessary”
• Note: Before your therapist provides services,
which are not medically reasonable and