Medicare Program Updates

Beginning in 2007, changes in the Medicare law were implemented that changed the structure and assignment of the Medicare Part B premium. The law mandates that in 2008 Medicare eligible persons who have an annual income of more than $80,000 per year and file an individual tax return; and married couples who file jointly, will have an increase to their Part B premium. Married couples who file jointly and have an income of more than $160,000 per year will also pay higher Part B premiums. The higher amounts will be assigned and deducted from Social Security checks beginning in January 2007.

The Part B premium amounts based on income will change each year. The amounts are listed below for 2008:


Individual Tax Filers	Joint Tax Filers	2007 Part B Premium
$82,000 or less	$164,000 or less	$96.40 monthly
$82,001 - $102,000	$164,001 - $204,000	$122.20 monthly
$102,001 - $153,000	$204,001 - $306,000	$160.90 monthly
$153,001 - $205,000	$306,001 - $410,000	$199.70 monthly
Above $205,000	Above $410,000	$238.40 monthly

People whose income level has decreased can appeal the determination of this increase. For more information about Part B premiums based on income, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-2078. You may also visit the Social Security website at www.socialsecurity.gov.

Medicare Premiums for 2008

Part A: (Hospital Insurance) Premium

Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
The Part A premium is $233 for people having 30-39 quarters of Medicare-covered employment.
The Part A premium is $423 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

$96.40 per month*

Medicare Deductible and Coinsurance Amounts for 2008:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered cost except the Medicare Part A deductible (2008 = $1,024) during the first 60 days and no more than 150 days.

For each benefit period you pay:

A total of $1,024 for a hospital stay of 1-60 days.
$256 per day for days 61-90 of a hospital stay.
$512 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
All cost for each day beyond 150 days.

Skilled Nursing Facility Coinsurance

$128 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

$135 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135 deductible.)

Information Resources

Help is available to assist you in selecting a prescription drug plan that meets your needs.

Begin your search by:

Visiting www.medicare.gov
Calling Medicare (1-800-633-4227 or TTY 1-877-486-2048)
Calling your state Health Insurance Assistance Program. In New York call 1-800-701-0501. *New York's State Health Insurance Assistance Program is known as Health Insurance Counseling and Assistance Program or HIICAPS.
Requesting a free copy of the booklet "Your Guide to Medicare Prescription Drug Coverage," CMS Publication Number 11109 on www.medicare.gov.
Specific local prescription drug information is available at www.medicare.gov or by calling your local Office for Aging. In New York you may call 1-800-701-0501, Five boroughs-311 or visit www.eldercare.gov
In selecting a drug plan consider your prescription drug needs, any coverage you may already have, costs, convenience, and availability in your area.

Appeals in Prescription Drug Plans

If you are a Medicare beneficiary enrolled in a prescription drug plan, you have the right to appeal decisions made by the plan if you are notified that your drug plan won't cover a prescription drug, or if you are asked to pay more than you think you are required to pay. It is also possible to ask your plan for an exception if you and your doctor believe you need a drug that isn't on your drug plan's list of covered drugs.

If you disagree with the information about your drug coverage provided by the pharmacist, ask for a notice in writing. When your drug plan receives your request for a coverage determination, they have 72 hours to make a decision (24 hours if the request is expedited). If you disagree with the decision, you must request your appeal in writing. Contact your drug plan for complete information about the appeals process. Always ask about additional appeal rights if decisions are not in your favor. Always check with your doctor about prescription drugs you are taking to discuss available options.

Medicare Savings Programs

Medicare Savings Programs provide help from state Medicaid programs to assist people with limited income. These programs continue to be available this year for those persons who qualify.

To qualify, you must:

Have Medicare Part A.
Be an individual with resources of $4000 or less or a couple with resources of $6000 or less. ** Resources include money in a savings or checking account, stocks, or bond.
You must be an individual with a monthly income of less than $1,169 or a married couple with a monthly income of less than $1,561. Depending on the Medicare Savings Program you qualify for, the level of assistance may pay Medicare premiums and in some instances may pay deductibles and co-insurance.
Call your state Medicaid office for information or call 1-800-633-4227 for your local number. Additionally, you may call the HIICAP program at 1-800-701-0501.

For information in New York call 1-800-333-4114 to ask about Medicare Savings Programs. You may wish to call your state Medical Assistance Program in New York (Medicaid.)