2022 Medicare Parts A & B Premiums and Deductibles / 2022 Medicare Part D Income-Related Monthly Adjustment Amounts

[Mary Wilson]

Nov 12, 2021
Medicare Part D
Medicare Parts A & B

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) released the 2022 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2022 Medicare Part D income-related monthly adjustment amounts

The increases in the 2022 Medicare Part B premium and deductible are due to:

• Rising prices and utilization across the health care system that drive higher premiums year-over-year alongside anticipated increases in the intensity of care provided.

• Congressional action to significantly lower the increase in the 2021 Medicare Part B premium, which resulted in the $3.00 per beneficiary per month increase in the Medicare Part B premium (that would have ended in 2021) being continued through 2025.

• Additional contingency reserves due to the uncertainty regarding the potential use of the Alzheimer’s drug, Aduhelm™, by people with Medicare. In July 2021, CMS began a National Coverage Determination analysis process to determine whether and how Medicare will cover Aduhelm™ and similar drugs used to treat Alzheimer’s disease. As that process is still underway, there is uncertainty regarding the coverage and use of such drugs by Medicare beneficiaries in 2022. While the outcome of the coverage determination is unknown, our projection in no way implies what the coverage determination will be, however, we must plan for the possibility of coverage for this high cost Alzheimer’s drug which could, if covered, result in significantly higher expenditures for the Medicare program.

https://www.cms.gov/newsroom/fact-s...care-part-d-income-related-monthly-adjustment

 

[Emily]

If they raise Medicare B or D for that drug, healthier lower income seniors will drop those plans. Why should they subsidize costs for wealthier seniors who can afford the 10k plus PET scans needed to start therapy, (not covered by Medicare), and the 10k plus annual out-of-pocket costs when they could never afford these costs themselves? If that happens, eventually we'll see poorer seniors fined for dropping out just as was done in the ACA.

The approval smacks of utter regulator compromise. If CMS is just using this debacle as a scapegoat for raising rates for other reasons, it was a dumb thing to do.

https://spectator.org/fda-alzheimers-drug-approval-aduhelm/
The Exploding Revolt Against the FDA’s Alzheimer’s Drug Approval
The reaction to Aduhelm’s approval from just about everyone who’s anyone has been overwhelmingly negative.
by Michael Fumento

July 27, 2021, 12:09 AM
...
Even before the FDA announcement, we knew the agency had ignored its entire 11-member panel (three of whom subsequently quit because of it) to approve Biogen’s Aduhelm. “There were, I think, six or seven reasons I voted no,” said one of the resignees, Aaron Kesselheim, associate professor of medicine at Harvard Medical School. For the agency to go against a unanimous panel vote, “that’s never happened,” said Wayne Pines, a former FDA senior official who has written histories about the agency.

Just this week we learned that a vast majority of a second FDA group of 15 officials who review complex issues found Aduhelm didn’t meet the threshold for “instilling public confidence in the usefulness of the drug” and another clinical trial was necessary, according to minutes of the meeting obtained by the New York Times. One member said approval could “result in millions of patients taking aducanumab without any indication of actually receiving any benefit, or worse, cause harm.”

In fact, the FDA did conclude there should be another trial but quite remarkably said it could occur after approval with no results due until 2029, giving the company eight years to sell the drug regardless. It admitted that one of the two major Aduhelm studies showed absolutely no benefit in aiding mental decline while at best the other may have shown a minor and perhaps real-world insignificant impact. So to grant approval, it changed the “endpoint” or goal. That endpoint was reducing the level of protein amyloid plaques that has long been observed to accompany Alzheimer’s...

https://www.fiercepharma.com/market...ttling-us-skepticism-looks-at-likely-european
Biogen's Aduhelm, already battling US skepticism, faces likely European rejection
by Angus Liu | Nov 17, 2021 10:20am
...
European regulators don’t plan to go down the same controversial path as their U.S. counterparts did in approving Biogen’s Eisai-partnered Alzheimer’s disease therapy, Aduhelm. And for Biogen, as one analyst sees it, 40% of potential revenue on the drug is going down the drain.

Biogen has received a “negative trend vote” on Aduhelm’s application from the European Medicines Agency’s (EMA's) Committee for Medicinal Products for Human Use (CHMP).
...
The Department of Veterans Affairs in August decided to leave Aduhelm off its formulary. The Centers for Medicare and Medicaid Services is expected to rule on how to cover Aduhelm for Medicare early next year. CMS has already said, though, that it is raising Medicare Part B’s premium by about 15% in 2022, pointing to the Biogen drug as a major driver for the increase.


In a revelation that further fuels doubts about Aduhelm, a recent update from the FDA Adverse Event Reporting System showed a patient death after treatment with the drug. A 75-year-old female in Canada died after she was diagnosed with brain swelling, or amyloid-related imaging abnormality, a known side effect of Aduhelm....

 

[Mary Wilson]

NOTE: This manual section 220.6 lists all Medicare-covered uses of PET scans. Except as set forth below in cancer indications listed as "Coverage with Evidence Development", a particular use of PET scans is not covered unless this manual specifically provides that such use is covered. Although this section 220.6 lists some non-covered uses of PET scans, it does not constitute an exhaustive list of all non-covered uses.

https://www.cms.gov/medicare-coverag...=AAAAEAAAAQAA&

(As with ALL diagnoses and procedures, ALL insurances cover only with a payable diagnosis.)
__________________________________________________ ____________________________

To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit:
https://www.medicare.gov/your-medica...vings-programs.

https://www.cms.gov/newsroom/fact-sh...hly-adjustment
__________________________________________________ ______________________________

In my opinion, it is best not to scare people with articles that provide misinformation.

 

[Mary Wilson]

I will be paying $11.70 per month for Medicare drug coverage in 2022.
And my Medicare Part B will be at a reasonable monthly premium.

 

[Mary Wilson]

Cost-of-Living Adjustment (COLA) Information for 2022

Social Security and Supplemental Security Income (SSI) benefits for approximately 70 million Americans will increase 5.9 percent in 2022.
The 5.9 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 64 million Social Security beneficiaries in January 2022. Increased payments to approximately 8 million SSI beneficiaries will begin on December 30, 2021.

https://www.ssa.gov/cola/
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Social Security beneficiaries will soon see the biggest jump in monthly checks in 40 years. How to prepare

PUBLISHED SUN, OCT 17 20219:00 AM EDT
Carmen Reinicke

https://www.cnbc.com/2021/10/17/people-will-get-bigger-social-security-checks-in-2022-how-to-prepare.html

 

[sharon sanders]

bump this

 

[Emily]

"In my opinion, it is best not to scare people with articles that provide misinformation"

Then tell that to someone who is scaring people with misinformation, IMO. Opinions or facts you don't like are not misinformation. You seem confused about Medicare B vs D. Infusions are usually covered by B, hence the increase to that fee, not part D. Your drug coverage is irrelevant. Medicare B is increasing from from $148.50 in 2021 to $170.10 in 2022.

https://www.cms.gov/newsroom/press-releases/cms-announces-2022-medicare-part-b-premiums