2016 Medicare Premiums, Coinsurance and Deductibles

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Updated January, 2016

2016 Medicare Premiums, Deductibles, and Copays

The Centers for Medicare and Medicaid Services (CMS) has announced the “new” Medicare premiums, deductibles, and coinsurance amounts for 2016. The standard Medicare Part B premium (single individuals with income of $85,000 or less; joint filers with income of $170,000 or less) remains the same as 2013 through 2015 at $104.90 FOR MOST PEOPLE (see below).

Higher Medicare premiums apply to folks with higher incomes or who are in different categories (see below).

Here are the essential Medicare figures:

  • Part B premium: $104.90
  • Part B deductible: $166
  • Part A deductible: $1,288 for hospital stays during initial 60 days
  • Co-payment for hospital stay days 61-90: $322/day
  • Co-payment for hospital stay days 91-150: $644/day
  • Patient responsible for ALL Part A costs beyond day 150 (thus the importance of a good Medicare supplemental policy)
  • Skilled nursing facility co-payment, days 21-100: $161/day for days 21-100

As directed by 2003 Medicare law and subsequent law, higher income beneficiaries or those fitting one of five groups below will pay higher Part B premiums. Social Security will base the premiums on reported income (for federal tax purposes) from two years previously (e.g., 2014 income for 2016 premiums).

If you are in one of these five groups you will pay $121.80 (unless your income throws you to an even higher group below).  Here are the five groups:

  • You first enroll in 2016
  • You don’t draw Social Security benefits
  • You are billed directly for Part B premiums
  • Your modified adjusted gross income is above one of the amounts below:

Individuals with annual incomes between $85,000 and $107,000 and married couples with annual incomes between $170,000 and $214,000 will pay in 2016 a monthly premium of $170.50.

Individuals with annual incomes between $107,001 and $160,000 and married couples with annual incomes between $214,001 and $320,000 will pay in 2016 a monthly premium of $243.60.

Individuals with annual incomes between $160,001 and $214,000 and married couples with annual incomes between $320,001 and $428,000 will pay in 2015 a monthly premium of $316.70.

Individuals with annual incomes of $214,001 or more and married couples with annual incomes of $428,001 or more will pay in 2015 a monthly premium of $389.80.

Part A Premiums

Because most people have 40 or more quarters of covered employment, they do not pay Medicare Part A premiums. Other people may “buy-in” to Medicare Part A – the most commonly effected individuals are those with disabilities who do not have a significant work history. The buy-in rates for Part A are up to $411 per month.