CMS Announces 2022 Medicare Cost-Sharing Amounts

Just so you are aware if you are not yet, Residents on SS/SSI will receive a 5.6% increase 1/1/2022, but Medicare is also going up.


Last week, the Centers for Medicare & Medicaid Services (CMS) announced changes to premiums, deductibles, and coinsurance amounts for Medicare Part A and Part B. For 2022, the Part B standard monthly premium will be $170.10, up from $148.50 in 2021. The Part B deductible will be $233, a $30 increase, and the Part A deductible will be $1,556 in 2022, a $72 increase. For most people with Medicare, their Part B premium increase will be covered by the 5.9% cost-of-living adjustment (COLA) in their 2022 Social Security benefits. Read more in CMS’s fact sheet on the 2022 Medicare Parts A & B Premiums and Deductibles/2022 Medicare Part D Income-Related Monthly Adjustment Amounts.  — Review and Blog


Confusion about Medicare plagues older workers

Contributions to health savings accounts can trip up enrollment after the age of 65.


Advocacy Opportunity

The Medicare Improvements for Patients and Providers Act (MIPPA) established a process in which the Social Security Administration (SSA) is required to transmit to state Medicaid agencies all verified information provided by applicants for the Medicare Part D Low Income Subsidy (LIS). States are then required to treat this information (called “leads data”) as verified and to process the LIS information as an application for Medicare Savings Program (MSP) enrollment.

The Centers for Medicare and Medicaid Services (CMS) recently issued an Informational Bulletin to state Medicaid programs emphasizing that, despite earlier guidance, some states have continued practices that do not meet the MIPPA statutory standard “because they do not meaningfully utilize the leads data and instead put the onus on the individual to separately apply for MSP.” Specific practices identified by CMS as inadequate include:

  • Sending a blank MSP application
  • Sending a letter instructing the applicant on how to apply for MSPs
  • Requesting information already contained in the leads data
  • Requesting additional documentation if the information can be obtained through data sources available to the state
  • Setting an effective date for MSP coverage that is later than the date of the LIS application.

CMS also provided state-by-state estimates of the percent and numbers of individuals whom it believes would qualify for MSPs but are not enrolled. Advocates can find the information for their state here. 

The Bulletin especially highlights under-enrollment in the Qualified Individual (QI) program. QI enrollment costs states nothing because states receive 100% federal match. Yet it is estimated that only 15% of individuals likely to qualify are enrolled. In 2020, $200 million in federal funds for QI went unspent.

To improve enrollment in all MSP programs, the CMS Bulletin suggests that states consider aligning MSP counting rules with LIS rules, accepting self-attestation of types of income and resources for which providing documentation may be onerous, and adopting outreach strategies, including partnering with SHIPs and others. In addition to the Bulletin suggestions, states also can raise income and asset limits above the federal minimum or, as has been done in several states, eliminate the asset test entirely.

In states with inadequate procedures for handling MIPPA leads data and states with low MSP enrollment, the Bulletin provides a good roadmap for advocating for improvements and an impetus for change.