2016 Elder Law Numbers

The Centers for Medicare and Medicaid Services (CMS) has released the new Medicare premiums, deductibles, and co-payments for 2016:

  • Basic Part B premium: $104.90/month * (no change from 2015)
  • Part B deductible: $166 (was $147 in 2015)
  • Part A deductible: $1,288 (was $1,260 in 2015)
  • Co-payment for hospital stay days 61-90: $322/day (was $315 in 2015); Co-payment for hospital stay days 91-150: $644/day (was $630 in 2015)
  • All costs for each day beyond 150 days
  • Skilled nursing facility co-payment, days 21-100: $161/day (was $157.50 in 2015)

Also, note that individuals with annual incomes over $85,000 and married couples with annual incomes over $170,000 will pay a higher Medicare Part B premium, with a minimum monthly premium of $170.50.

CMS has also released the 2016 guidelines for how much spouses of institutionalized Medicaid recipients may keep.

  • Maximum Community Spouse Resource Allowance: $119,220 (no change from 2015)
  • Minimum Community Spouse Resource Allowance: $23,844 (no change from 2015)
  • Maximum Monthly Maintenance Needs Allowance: $2,980 (no change from 2015)
  • Minimum Monthly Maintenance Needs Allowance: $1,991.25 (thru June 30, 2016, was $1,966.25)
  • Medicaid Waiver Benefits Income Cap: $2,199 per month (no change from 2015)
  • Pennsylvania Medicaid penalty divisor: $9,198.61 ($302.42/day), as of 1/1/16
  • New Jersey Medicaid penalty divisor: $10,116 ($332.59/day) since 4/1/15

*There will be no Social Security cost of living increase in 2016. As a result, most people with Medicare Part B will be “held harmless” from any increase in Part B premiums in 2016. Beneficiaries not subject to “held harmless” provision will pay $121.80. The premium increases relative to income. Medicare Part B beneficiaries not subject to the “hold harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid and beneficiaries who pay an additional income related premium.

2016 Elder Law Numbers

About Jerry

Jerold E. Rothkoff, a practicing New Jersey and Pennsylvania attorney, is the Principal of the Rothkoff Law Group, an elder care law firm. Jerry dedicates his practice to serving clients in the areas of life care planning, long-term care planning, Medicaid & VA benefits, and advocacy for the elderly and disabled. He is past President of the NJ Chapter of the National Academy of Elder Law Attorneys, former chair of the elder law section of the NJ State Bar Association, and past President of the Life Care Planning Law Firm Association. Jerry continues to be an outspoken advocate for the rights of the elderly and disabled. He writes for and gives presentations regularly to attorneys and other professionals about legal issues related to seniors and those with disabilities. Jerry’s community activities include the Twilight Wish Foundation, the Delaware Valley Stroke Council, the Alzheimer’s Association, as well as numerous other advocacy groups. When not in the office, Jerry spends time with his wife, Erica, and their five children, eighteen-year old identical twin girls, Liza and Julia, fifteen-year old fraternal twin boys, Evan and Gregory, and six-year old Aitan.

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