Medicare Updates for 2013
- Details
- Category: Uncategorized
- Written by Sally Thimm OTRL
Florida Medicare Update Items for 2013
Update to
Medicare deductibles, coinsurance, and premium rates for 2013
Effective date: January
1, 2013
Implementation date: January
7, 2013
The Centers for Medicare & Medicaid
Services (CMS) have updated deductibles, coinsurance, and premium rates for
Medicare beneficiaries for 2013.
Most beneficiaries covered by Medicare Part A receive coverage
without a premium. However, some patients who have extended hospital stays or
extensively use other covered Part A services may be subject to deductibles and
coinsurance requirements. Also, certain aged and disabled persons who
voluntarily enroll may be subject to the payment of a monthly premium.
Under Part B of the supplementary medical insurance (SMI) program,
all enrollees are subject to a monthly premium. Most SMI services are subject
to an annual deductible and coinsurance which are set by law.
2013
Part A, Hospital Insurance (HI)
Deductible - $1,184.00
Coinsurance:
• $296.00 a
day for 61st-90th day
• $592.00 a
day for 91st-150th day (lifetime reserve days)
• $148.00 a
day for 21st-100th day (skilled nursing facility coinsurance)
Base Premium (BP) - $441.00 per month * Additional charges are
added (as noted below) under certain circumstances.
BP with 10 percent surcharge - $485.10 a month
BP with 45 percent reduction - $243.00 a month (for those who have
30-39 quarters of coverage)
2013
Part B - Supplementary Medical Insurance (SMI)
Base Premium (BP) with 45 percent reduction and 10 percent surcharge
- $267.30 a month
Standard Premium - $104.90 a month
Deductible - $147.00 a year
Coinsurance - 20 percent.
Outpatient
therapy cap values for 2013 set at $1,900
Effective date: January
1, 2013
Implementation date: January
7, 2013
Outpatient therapy caps for 2013 will be $1900 for physical
therapy and speech-language therapy combined and $1900 for occupational
therapy.
Frequently Used Toll-Free Numbers
National Medicare
Beneficiaries Helpline-
1-800-MEDICARE
(1-800-633-4227)
1-877-486-2048
(TTY/TDD toll-free line for hearing or speech-impaired individuals)
Florida's
Prescription Drug Monitoring Program
http://www.doh.state.fl.us/mqa/pdmp/home.html
Preventive & Screening
Services
http://www.medicare.gov/coverage/preventive-and-screening-services.html
Flu Season is Upon Us!
According
to the Centers for Disease Control and Prevention, the flu virus is beginning
to increase and further increases are expected in the coming weeks and months.
Now is the time to protect against flu before activity increases within the Floridian
community.
**Remember
– the Influenza and pneumococcal vaccines and their administration fees are
covered Part B benefits. Influenza and pneumococcal vaccines are NOT Part
D-covered drugs.
Influenza Vaccines Pricing List
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/VaccinesPricing.html
The Affordable Care Act
Medicare Drug Discounts
http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html
Medicare Preventive Services
http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html
$250 "Donut Hole" Rebate (2010)
http://www.healthcare.gov/law/features/65-older/donut-hole-rebate/index.html
Ambulance Inflation Factor for CY 2013 and
Productivity Adjustment
On March 23, 2010, Section
3401 of the Affordable Care Act amended Section 1834(l)(3) of the Act to
require that specific Prospective Payment System and Fee Schedule update
factors be adjusted by changes in economy-wide productivity. The statute
defines the productivity adjustment to be equal to the 10-year moving average
of changes in annual economy-wide private nonfarm business Multi-Factor
Productivity (MFP) (as projected by the Secretary for the 10-year period ending
with the applicable fiscal year, cost reporting period, or other annual
period). The MFP for Calendar Year (CY) 2013 is 0.90 percent and the CPI-U for
2013 is 1.70 percent. According to the Affordable Care Act, the CPI-U is
reduced by the MFP, even if this reduction results in a negative AIF update.
Therefore, the AIF for CY 2013 is 0.80 percent.