Identification Number:
HI 00610 TN 1
Intended Audience:See Transmittal Sheet
Originating Office:Centers for Medicare & Medicaid Services (CMS)
Title:Supplementary Medical Insurance
Type:POMS Transmittals
Program:Medicare,Medicaid
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 006 – Covered Services (HI-SMI)
Subchapter 10 – Supplementary Medical Insurance
Transmittal No. 1, 01/19/2021

Audience

PSC: CS, IES, RECONR, SCPS;
OCO-OEIO: BET, CR, CTE, EIE, FCR, PETL;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

CMS

Effective Date

Upon Receipt

Background

This is a QAT and no changes to policy and procedure.

Summary of Changes

HI 00610.430 Annual Part B Cash Deductible

 

HI 00610.430 Annual Part B Cash Deductible

A deductible must be satisfied in each calendar year before payment may be made under SMI.

Bills count toward the deductible on the basis of incurred rather than paid expenses and are subject to a reasonable charge determination.

From 2020 through 2021, the deductible is $203.

From 2019 through 2020, the deductible is $198.

From 2018 through 2019, the deductible is $185.

From 2017 through 2018, the deductible is $183.

From 2016 through 2017, the deductible is $166.

From 2014 through 2015, the deductible is $147.

As of January 1, 1982, the deductible is $75.

From 1973 through 1981, the deductible was $60.

From 1966 through 1972, the deductible was $50.

The date of service determines when expenses were incurred, but expenses will be allocated to the deductible in the order in which the bills for those expenses are received by the carrier.

Even though an individual is not eligible for the entire calendar year; i.e., his coverage begins after the first month of the year, he must nevertheless, satisfy the full deductible.


HI 00610 TN 1 - Supplementary Medical Insurance - 1/19/2021