In order for a health plan to qualify as an HSA compatible High Deductible Health Plan, they must have a minimum annual deductible amount that applies to almost all services and items covered under the plan. The MMA allows that the minimum deductible may be adjusted annually. Plans may set deductibles higher than the minimum, and there is no maximum, although there is a maximum annual HSA contribution that may be funded as discussed below. For 2008, the deductibles remain unchanged from 2007. The 2008 and historical minimum deductible amounts are:

HSA compatible High Deductible Health Plans may not have total applicable out of pocket expenses exceeding a specified amount, which the MMA also allows to be adjusted annually. IRS Guidance has indicated out-of-network expenses as do not have to be applied towards the out-of-pocket expense maximum. The 2008 and historical maximum out of pocket amounts are:
   

Out of Pocket Expenses	2008	2007	2006	2005	2004
Single Annual Maximum	$5,600	$5,500	$5,250	$5,100	$5,000
Family Annual Maximum	$11,200	$11,000	$10,500	$10,200	$10,000

While there is no maximum limit to HDHP annual deductibles, there is an annual maximum limitation on Health Savings Account contributions, which the MMA also allows to be adjusted annually. The 2008 and historical maximum for HSA contributions are:

HSA Maximum Contributions	2008	2007	2006	2005	2004
Single Annual Contribution	$2,900	$2,850	$2,700	$2,650	$2,600
Family Annual Contributions	$5,800	$5,650	$5,450	$5,250	$5,150

CMS annually updates Medicare Beneficiary  premiums, deductibles and co-payments, using formula driven  adjustments set by statute.  By law, the standard Part B premium must be sufficient to cover 25 percent of the program’s costs,  with Medicare bearing  the remaining 75 percent.  Similarly, statutory formulas are used to determine the Medicare Part B deductible, the Part A deductible for hospital stays and other enrollee contributions.

In accordance with the Medicare Modernization Act, single beneficiaries and married couples with annual incomes exceeding a specified amount now pay a higher percentage of the cost of Medicare Part B coverage, through the Part B premium. These higher-income beneficiaries will pay a monthly premium equal to 35, 50, 65, or 80 % of the total cost, depending on their income level, by the end of the 3-year transition period that started in 2007.

* standard premium rate before income-related monthly adjustment

The 2008 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow(er) with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or joint tax return are: 

The monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at some time during the taxable year are: 

Premiums for Medicare Part D (the new prescription drug benefit set forth under the MMA) are variable by the plan vendor, with premium rates set on an annual basis. Cost sharing is subsidized for qualified Medicaid/Medicare crossovers and specified low-income beneficiaries. The MMA allows for the deductible, and variable coinsurance coverage levels to increase on an annual basis in subsequent years. The standard benefit and cost sharing for 2008 is:

• Annual Deductible of  $275 ($265 in 2007 and $250 in 2006);
• 25% Coinsurance for the cost of covered drugs between $276 and $2,510 (between $266 and $2,400 in 2007 and (between $251 and $2,250 in 2006);
• 100% Coinsurance (no plan coverage) of the cost of covered drugs between $2,511 and $5,726.25 (between $2,401 and $5,451.25  in 2007 and between $2,251 and $5,100 in 2006);
• The Maximum beneficiary annual out of pocket, which determines the upper limit of no plan coverage as stated above is $4,050 ($3,850 in 2007 and $3,600 in 2006);  and
• 5% coinsurance of the cost of covered drugs above $5,726.25 (or a copayment of $2.25 for covered generics and $5.60 for covered brand-name drugs—whichever is greater). [For 2007 these amounts were 5% coinsurance of the cost of covered drugs above $5,451.25 (or a copayment of $2.15 for covered generics and $5.35 for covered brand-name drugs)—whichever is greater; and For 2006, these amounts were 5% coinsurance of the cost of covered drugs above $5,101 (or a copayment of $2.00 for covered generics and $5.00 for covered brand-name drugs)—whichever is greater.]
• The threshold for the 100% coverage ($5,726.25) is calculated as follows: (A) Calculate out of pocket costs for 25% coverage range: 25% * ($2,510-$275) =  $558.75; (B) add deductible to (A): $275 + $558.75 = $833.75; (C) Subtract (B) from Out of Pocket Maximum: $4,050 - 833.75 = $3,216.25; (D) add upper limit of 25% coverage range to (C): $2,510 + 3,216.25 = $5,726.25

A CMS 4/12/2007 Memorandum from the Center for Beneficiary Choices details the Part D Deductibles and Maximums for 2008:
http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/downloads/PartDAnnouncement2008.pdf 

• Hospitals and Convenient Care: The Financial, Legal and Market Landscape, December 6th, 2007
• Future Care Web Summit, January 17th, 2008
• Transfer DRGs - Newest Underpayment Battleground, February 21st, 2008
• CD-ROMs of past events
• Upcoming Events

Save the Date: The National Predictive Modeling Summit, December 13 - 14, 2007, Hyatt Regency on Capitol Hill, Washington, DC, http://www.PredictiveModelingSummit.com 

Discounts: 
MCOL Paid Members get 50% off HealthcareWebSummit events; 10% off MCOL products; 5% off all other products through the Managed Care Store and special discounts for selected conferences