Medi-Cal Eligibility and the 2017 SSA COLA and Medicare Premiums

DHCS has issued guidance and provided resources on dealing with the 2017 SSA Cost of Living Adjustment (COLA) and the new Medicare premiums.  In 2017, the COLA is 3%.  Meanwhile, Part B premiums will be either $109 (current Medicare beneficiaries paying through SS deductions and low income Medicare beneficiaries who are not new to Medicare) or $134 (Medicare beneficiaries without the SS deduction or those who are new to Medicare).

For Medi-Cal only beneficiaries who do not pay the Part B premium (as well as for Pickle eligible individuals), the current SSA gross amount is multiplied by 1.003 for the 2017 gross SSA amount, then rounded down to the nearest dollar.  This amount is used for any relevant share of cost calculation.

For beneficiaries who have the Part B premium deducted from their SS benefit, the 2017 gross benefit is determined by adding the Part B premium to the net 2016 benefit, multiplying by the COLA, and rounding down to the next lower $0.10 increment.  From there, the 2017 Part B premium is subtracted and rounded down to the nearest dollar.  This amount will be used to determine share of cost.

For a Pickle applicant who pays the Part B premium through SS deduction, the 2017 gross benefit amount is calculated in the same manner as those with Part B deductions described above.  That amount is then multiplied by the relevant Pickle disregard multiplier, then rounded down to the nearest whole dollar to determine the 2017 disregard amount.  The disregard amount is then subtracted from the 2017 gross benefit amount.

Note that processing the 2017 COLA will not affect MAGI eligibility groups via CalHEERS.

DHCS ACWDL 17-02 (January 13, 2017).

Guidance on COLAs and Health Insurance Costs

DHCS has issued guidance about the effect of this year’s lack of a Social Security COLA on Medicare premiums and costs, along with other programs such as the Pickle program.

The Medicare Part A premium increased to $411 for those who do not receive free Part A; the reduced Part A premium is $226.  Part B premiums will stay at $104.90 for current Medicare beneficiaries who have the premium deducted from Social Security; those new to Medicare this year, or those who do not have Part B deducted from their Social Security check, will pay $121.90.  Those with higher incomes will pay higher premiums.

Medi-Cal resource limits remain at $2000 for an individual and $3000 for a couple.  DHCS ACWDL 16-05 (4/15/16).

Medicare Savings Program property limits remain unchanged: $7280 for an individual and $10930 for a couple.  DHCS ACWDL 16-07 (4/21/16).

Updates to SSI Allocations and MSP property limits

DHCS has informed counties about the increase in the standard and parent allocations for SSI in 2015.  This DHCS letter also includes information about the decrease in Medicare Part A premiums, and the lack of change for Part B premiums and deductibles.  Similarly, the property levels for the various Medicare Savings Programs remain at $7,160 for an individual and $10,750 for a couple.  DHCS ACWDL 15-13 (3/3/15).