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Date: Friday, Oct. 16, 1998 FOR IMMEDIATE RELEASE Contact: HCFA Press Office (202) 690-6145
For 1999, the Medicare Part B premium will increase $1.70 a month -- the first increase since 1997 -- for a total monthly premium of $45.50. For most seniors, this amount is deducted from the monthly Social Security check. This is $5 less than the premiums that the Congressional Budget Office estimated in the Balanced Budget Act.
The Medicare Part A deductible for inpatient hospital care will rise by $4, about 0.5 percent, to $768. The small increase largely reflects savings from reductions in Medicare hospital payments and other program changes signed into law in the balanced budget agreement to help protect and preserve the Medicare Hospital Insurance Trust Fund. Last year, the deductible also rose by only $4.
The Part B premium covers physician services, hospital outpatient care, durable medical equipment and other services outside hospitals.
The Part A deductible is a beneficiary's only cost for the first 60 days of inpatient hospital care. The beneficiary coinsurance for hospital stays longer than 60 days is rising by $1 to $192 a day, while the beneficiary coinsurance for stays longer than 90 days will increase by $2 to $384 a day. The skilled-nursing facility coinsurance, which must be paid after the first 20 days of skilled-nursing care, will increase by 50 cents to $96 a day.
While the vast majority of Medicare's 39 million beneficiaries do not pay premiums for Part A coverage, the 360,000 who do will see no increase in 1999. The full monthly Part A premium will remain at $309. It is paid by seniors with less than 30 quarters of Medicare-covered employment and by disabled individuals under 65 who lost disability benefits because of work and earnings. Seniors with 30 to 40 quarters of Medicare-covered employment are entitled to reduced premiums that also will remain the same as last year -- $170 a month.
For many elderly and disabled people served by Medicare, Medicaid helps pay premiums, deductibles and coinsurance, said Nancy-Ann DeParle, administrator of the Health Care Financing Administration, which oversees Medicare and Medicaid.
"Many beneficiaries are eligible for help in paying their Medicare premiums, deductibles and coinsurance through their state Medicaid programs, but they often are unaware of this additional assistance," DeParle said.
About 5.2 million Medicare beneficiaries who have low incomes and limited resources now receive help from the Medicaid program. Most so-called "dual eligibles" may also qualify for the full range of Medicaid benefits in addition to payment of Medicare premiums, deductibles and coinsurance. These people become eligible principally because they either receive cash benefits from the federal Supplemental Security Income program, reside in a nursing home, or have so many medical needs that the cost of their care relative to their income meets the "medically needy" standard set by each state.
Other low-income beneficiaries -- known as Qualified Medicare Beneficiaries (QMBs), Specified Low-Income Medicare Beneficiaries (SLMBs) or Qualifying Individuals (QIs) -- also get help to cover Medicare's out-of-pocket costs. QMBs have incomes below the federal poverty level -- $7,698 for a single person 65 or older -- and limited financial assets. They are not always eligible for full Medicaid benefits, but Medicaid does pay their Medicare Part B premiums and all deductibles and coinsurance. The administration has also launched an outreach campaign through the Social Security Administration and the Health Care Financing Administration to assure that beneficiaries know they are eligible for premium assistance.
SLMBs have incomes between 100 percent and 120 percent of the poverty level and limited financial assets. Medicaid pays these beneficiaries' Medicare Part B premiums. QIs have incomes between 120 percent and 175 percent of the poverty level and limited financial assets. Medicaid pays all or part of these beneficiaries' Part B premiums.