2007 Medicare Cost Sharing rates

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ALJ/MAC Decision Database

MEDICARE PREMIUMS AND DEDUCTIBLES FOR 2007

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Hospital Deductible: $992 / benefit period

Hospital Coinsurance:

Days 0-60: $0
Days 61-90: $248 / day
Days 91-150: $496 / day

Skilled Nursing Facility Coinsurance

Days 0-20: $0
Days 21-100: $124 / day

Part A Premium (for voluntary enrollees only)

With 30-39 quarters of Social Security coverage: $226 / month
With 29 or fewer quarters of Social Security coverage: $410 / month

Part B

Deductible: $131 / year
Standard Premium: $93.50 / month

Part B Income-Related Premium

Beneficiaries who file an individual tax return with income:	Beneficiaries who file a joint tax return with income:	Income-related monthly adjustment amount	Total monthly premium amount
Less than or equal to $80,000	Less than or equal to $160,000	$0.00	$93.50
Greater than $80,000 and less than or equal to $100,000	Greater than $160,000 and less than or equal to $200,000	$12.30*	$105.80*
Greater than $100,000 and less than or equal to $150,000	Greater than $200,000 and less than or equal to $300,000	$30.90*	$124.40*
Greater than $150,000 and less than or equal to $200,000	Greater than $300,000 and less than or equal to $400,000	$49.40*	$142.90*
Greater than $200,000	Greater than $400,000	$67.90*	$161.40*

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-related monthly adjustment amount	Total monthly premium amount
Less than or equal to $80,000	$0.00	$93.50
Greater than $80,000 and less than or equal to $120,000	$49.40*	$142.90*
Greater than $120,000	$67.90*	$161.40*

* Adjustments to these amounts were announced in 71 Fed. Reg. 55480 (Friday, September 22, 2006)

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 ($93.50 / month in 2007),
Must live in the plan’s service area,
Must not have end-stage renal disease (ESRD) at time of enrollment.