Medicare Premiums, Deductibles, and Copays Change for 2016

Here are the new numbers for Medicare premiums, deductibles, and copays for 2016.

Part A Costs

Most people don't pay a monthly premium for Medicare Part A (hospital insurance). But if you have to pay for Part A because you or your spouse doesn’t have a long enough work history, you'll pay between $226 (for 30-39 work credits) and $411 (for fewer than 30 work credits).

In 2016, you’ll also pay a $1,288 deductible for each benefit period in which you use hospital or skilled nursing inpatient care, in addition to the following copays.

  • Hospital days 61-90: $322 coinsurance per day of each benefit period
  • Hospital days 91 and beyond: $644 coinsurance per each lifetime reserve day for each benefit period
  • Skilled nursing days 21-100: $161 coinsurance per day of each benefit period.

Part B Costs

Most people pay a Part B premium of $104.90 each month (unchanged from 2014 or 2015). But if you first enroll in Medicare Part B during 2016, or you are not collecting Social Security benefits, your premium will be $121.80 per month. Also, if your adjusted gross income is over $85,000 (or $170,000 for a couple), the monthly premium is higher, but the high-income premiums have not changed from 2014.

The Part B deductible for 2016 is $166 per year.

There are also caps on the following Part B services for 2016:

  • Cap on outpatient physical therapy and speech-language pathology combined: $1,960
  • Cap on occupational therapy: $1,960.

Part D Costs

Part D premiums vary depending on the plan you choose. The Part D deductible for 2016 is $360 per year (though some plans waive the deductible).

In 2016, the “donut hole” (coverage gap) begins at $3,310 and ends at $4,850. However, in 2016, while you are in the donut hole, brand-name drugs must be sold to you at a 55% discount and generic drugs at a 42% discount.

There are subsidies available to pay for Part D for those with low income (called Extra Help). See Nolo’s article on Extra Help for Part D for eligibility numbers for 2016.