Medicare Blog

what does medicare hold harmless mean

by Jaclyn Beier Published 3 years ago Updated 2 years ago
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The Medicare hold-harmless provision is a special rule designed to protect retirees’ Social Security checks from rising Medicare Part B costs. If Medicare Part B premiums rise higher than the cost-of-living-adjustment, the recipient's premium cost will be reduced instead of their Social Security benefit checks.

Last Updated: November 30, 2021
A special rule called the “hold harmless provision” protects your Social Security benefit payment from decreasing due to an increase in the Medicare Part B
Medicare Part B
The Parts of Medicare

Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
https://www.ssa.gov › benefits › medicare
premium
. The Part B base premium for 2022 is $170.10, which is $21.60 higher than the 2021 base premium.
Nov 30, 2020

Full Answer

What is the Medicare hold harmless provision?

The Medicare hold harmless provision prohibits Medicare Part B premiums from reducing the amount of your Social Security benefits year over year. This limits the rise in Medicare Part B premiums paid by Social Security beneficiaries in a given year to no more than the cost of living increase provided by Social Security.

What does the hold harmless rule mean for You?

The other thing to remember about the hold-harmless provision is that it doesn't permanently reduce your monthly Medicare premiums. When future-year COLAs exceed the increase in Medicare costs, then you'll have to make up the difference with additional Medicare premium boosts that you temporarily avoided because of the rule.

What is the hold harmless provision for Social Security Part B?

To qualify for reduced payments under the hold harmless provision, individuals must receive Social Security benefits and must have had their Part B premiums paid out of those Social Security benefits for at least two months in the previous year.

What is the hold-harmless provision?

Instead, what the hold-harmless provision did was compare the $5 per month dollar increase in Medicare premiums to whatever the 1.7% COLA translated to for each Social Security recipient. For an average retired worker with a benefit of about $1,300, the COLA worked out to $22 per month.

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What is a Medicare hold?

The Medicare hold harmless provision stems from a statutory restriction that prevents Medicare from raising most Social Security recipients' Medicare Part B premiums by more than the cost of living adjustment (COLA) provided by Social Security in a given year.

What is the Social Security hold harmless rule?

There is a special rule for Social Security recipients, called the "hold harmless rule," that ensures that Social Security checks will not decline from one year to the next because of increases in Medicare Part B premiums. The hold harmless rule applies to most, but not all, Social Security recipients.

Why does Medicare Part B go up every year?

And in recent years Part B costs have risen. Why? According to CMS.gov, “The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs. These higher costs have a ripple effect and result in higher Part B premiums and deductible.”

Why is my first Medicare bill so high?

If you're late signing up for Original Medicare (Medicare Parts A and B) and/or Medicare Part D, you may owe late enrollment penalties. This amount is added to your Medicare Premium Bill and may be why your first Medicare bill was higher than you expected.

Why is my Medicare Part B premium so high?

If you file your taxes as “married, filing jointly” and your MAGI is greater than $182,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $91,000, you'll pay higher premiums.

How much does Social Security take out for Medicare each month?

The standard Medicare Part B premium for medical insurance in 2021 is $148.50. Some people who collect Social Security benefits and have their Part B premiums deducted from their payment will pay less.

How do I get my $144 back from Medicare?

Even though you're paying less for the monthly premium, you don't technically get money back. Instead, you just pay the reduced amount and are saving the amount you'd normally pay. If your premium comes out of your Social Security check, your payment will reflect the lower amount.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

How can I reduce my Medicare Part B premium?

To request a reduction of your Medicare premium, contact your local Social Security office to schedule an appointment or fill out form SSA-44 and submit it to the office by mail or in person.

Does Medicare get deducted from your Social Security check?

Yes. In fact, if you are signed up for both Social Security and Medicare Part B — the portion of Medicare that provides standard health insurance — the Social Security Administration will automatically deduct the premium from your monthly benefit.

What will Medicare cost in 2021?

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020.

Is Medicare free at age 65?

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

What is the hold harmless provision for Medicare?

The Medicare hold harmless provision stems from a statutory restriction that prevents Medicare from raising most Social Security recipients’ Medicare Part B premiums by more than the cost of living adjustment (COLA) provided by Social Security in a given year. The administration calculated the adjustment for 2021 at 1.3%. 1 

Do you have to pay out of your Social Security for Medicare Part B?

To qualify for reduced payments under this provision, you must receive Social Security benefits and have Part B premiums paid out of those benefits for at least two months in the previous year. Those who make payments for Part B insurance directly to Medicare and those who have premiums paid by Medicaid do not qualify and, as a result, may be subject to higher premiums. 2 

What Is the Medicare Hold Harmless Provision?

What is the hold harmless provision in Medicare? It sounds like a fancy legal term, but it’s actually a simple protection put in place for recipients. It ensures that this year’s Medicare premium increases won’t completely eliminate the cost of living increase you received this year.

Hold Harmless Provision Requirements

Once you understand what the hold harmless agreement represents in Medicare, it’s time to look at some of the exceptions to the provision. In order to cap your Medicare increases, you have to meet the following criteria as a Social Security recipient:

Special Considerations

COLA has been pretty good to Social Security recipients in recent years. But it wasn’t too long ago that the economy was suffering, leading the COLA to fall to zero. In 2016, this was the case for only the third time in 40 years. The cost of Medicare for social security recipients had to stay stagnant because of the hold harmless provision.

Final Thoughts

Inflation is inevitable, but at least Social Security recipients know they’ll get a raise to compensate for it. Medicare premiums could increase, as well, though. Thanks to the hold harmless provision, Social Security recipients have the confidence of knowing they won’t lose money because premiums increased more than the cost of living.

Lower COLA, higher premiums

In 2016, the COLA is expected to be zero (see chart below). This won’t impact the majority of Medicare beneficiaries who fall under the hold harmless rule. By law, they won’t face any premium increases next year. Instead, they’ll continue to pay the current premium of $104.90.

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Any COLA-related increases have not formally passed yet. But once they do, those affected must pay the higher premiums. As such, those paying their premiums directly to Social Security should sign up for Social Security before the end of the year.

Many misunderstand how the rule works

Retirees need help with basic living expenses, and healthcare is a vital need for people as they age. Together, Social Security and Medicare aim to give retirees vital assistance with their medical and financial obligations.

Why the hold-harmless provision exists

The hold-harmless provision stemmed from the fact that the CMS and SSA work together to facilitate their joint operations. Online applications for both Social Security and Medicare run through a page on the SSA website, and those who visit Social Security offices in person can apply for both benefits at the same time if they so choose.

How hold-harmless really works

Many people mistakenly believe that the hold-harmless provision kicks in whenever percentage increases in Medicare costs outpace Social Security's COLA percentage. That would be ideal in helping retirees keep as much of their benefits as possible. However, that's not the way the rule works.

A temporary benefit

The other thing to remember about the hold-harmless provision is that it doesn't permanently reduce your monthly Medicare premiums. When future-year COLAs exceed the increase in Medicare costs, then you'll have to make up the difference with additional Medicare premium boosts that you temporarily avoided because of the rule.

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How to qualify for hold harmless?

To qualify for the hold harmless provision, you must: Receive Social Security benefits or be entitled to Social Security benefits for November and December of the current year. Have your Medicare Part B premiums for December and January deducted from your monthly benefits.

Why do people pay Medicare premiums?

Most people with Medicare will pay the new premium amount because the increase in their benefit amount will cover the increase. However, a small number of people will see little or no increase in their Part B premium — and their Social Security benefit checks will remain the same — because the amount of their cost-of-living adjustment isn’t large ...

Does Social Security reduce Medicare?

Social Security works together with the Centers for Medicare & Medicaid Services to make sure you won’t have a reduction in your Social Security benefits as a result of Medicare Part B premium increases.

Does hold harmless apply to Part B?

The hold harmless provision does NOT apply to you if: You enroll in Part B for the first time in 2021. You pay an income-related monthly adjustment amount premium. You are dually eligible for Medicaid and have your premium paid by a state Medicaid agency. You can learn more by visiting Medicare. Tags: Medicare.

What is the hold harmless rule?

The hold harmless rule protects you from having your previous year’s Social Security benefit level reduced by an increase in the Part B premium so long as: You are entitled to Social Security benefits for November and December of the current year (2019);

Does Hold harmless apply to 2020?

You are new to Medicare in 2020. Hold harmless does not apply to you because you have not been enrolled in Medicare Part B long enough to qualify. You are subject to IRMAA. You are enrolled in a Medicare Savings Program (MSP). However, the MSP should continue paying for your full Part B premium.

How much is the hold harmless premium for Medicare?

Almost half of Part B Medicare recipients who are subject to the hold-harmless provision for 2018 will pay the full monthly premium of $134 because the 2% increase in Social Security will cover the increased Part B premiums.

Why is Social Security not lowering?

Most Social Security recipients are protected from having their check lowered due to rising Medicare Part B premiums. By Elizabeth Dickey. There is a special rule for Social Security recipients, called the "hold harmless rule," that ensures that Social Security checks will not decline from one year to the next because of increases in Medicare Part ...

What is the COLA for Social Security?

COLA usually causes Social Security checks to go up, but when consumer prices drop, the COLA is lower or is eliminated altogether. In 2018, the COLA is 2.0%. In 2017, the COLA was 0.3%, in 2016, there was no COLA, and in 2015, the COLA was 1.7%. In 2014, the COLA was 1.5%.

How much is Medicare Part B?

How Much Is the Medicare Part B Premium? Medicare premiums have ridden steadily every year until now. The monthly premium for Medicare Part B rose to $134 in 2018, up from $109 in 2017, up from $121.80 in 2016. (Medicare Part B pays for outpatient services like doctor visits and medical equipment.

Does the hold harmless rule apply to Medicare?

In addition, there are low-income Medicare recipients whose Medicare premiums are paid by their state Medicaid agencies, and those premiums are not protected by the hold harmless provision. The hold harmless rule also does not apply to the Medicare Part D (prescription drug) premium, but that program just started in 2006 ...

Can you have a reduction in your Social Security check to pay for Medicare premiums?

When Medicare premiums were climbing each year, without the COLA keeping pace, it was possible for a Social Security recipient to have a reduction in their Social Security check to pay for the increased Medicare premium. Fortunately, the "hold harmless" rule prevented that from happening for most Social Security recipients.

What is a hold harmless clause?

A hold harmless clause is a legal statement that an individual or enterprise will not be held liable for the risk, danger, injury, or damages to another party. 13 min read. 1.

What is the difference between indemnity and hold harmless?

The distinction between indemnity clauses and hold harmless clauses varies from state to state. Many legal professionals behave as though these terms are similar, but there are subtle differences that lead some professionals to favor one over the other.

What happens if a contract is not drafted with care and precision?

If such contracts are not drafted with care and precision, there can be negative fall-out from circumstances that were not planned for. You are proposing a covenant. A hold harmless clause is common in the case of a covenant between two parties when one party decides to make a change of their own volition.

Do contractors have to have a hold harmless clause?

Contractors: Contractors may require a hold harmless clause from those purchasing their services. For example, a contractor may agree to perform a service for a home renovation project on the condition that if any piece of his work causes harm later, he will not be held liable financially or legally.

Can a hold harmless clause protect you from liability?

A hold harmless agreement may not always protect from liability. The reality is that some states and nations do not respect such clauses, and even where they are respected, such clauses can generally be argued 45against if they are worded too vaguely. It would be simple to attach a hold harmless clause to anything one does, but the clause can only be enforced if the company or individual gives a fair assessment of the risk involved and all parties are aware and prepared. These concepts should be made explicit with detailed language.

Do hold harmless clauses have to be included?

A Solution. It is generally best to include both terms for maximum clarity. You can also add extra wording, just in case, to show what the indemnifying person is protecting.

Is a hold harmless agreement relative to the state in which it is written?

In general, such an agreement is relative to the state in which it is written, as different areas perceive a hold harmless agreement in different lights. Sometimes, the contract will protect the contractor from major companies or parties not even associated with the agreement.

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What Is The Medicare Hold Harmless Provision?

  • What is the hold harmless provision in Medicare? It sounds like a fancy legal term, but it’s actually a simple protection put in place for recipients. It ensures that this year’s Medicare premium increases won’t completely eliminate the cost of living increase you received this year. Here’s an example of the Medicare Part B hold harmless provision....
See more on retirable.com

Hold Harmless Provision Requirements

  • Once you understand what the hold harmless agreement represents in Medicare, it’s time to look at some of the exceptions to the provision. In order to cap your Medicare increases, you have to meet the following criteriaas a Social Security recipient: 1. You must have been entitled to benefits in both November and December of the current year. 2. Medicare Part B premiums mus…
See more on retirable.com

Special Considerations

  • COLA has been pretty good to Social Security recipients in recent years. But it wasn’t too long ago that the economy was suffering, leading the COLA to fall to zero. In 2016, this was the case for only the third timein 40 years. The cost of Medicare for social security recipients had to stay stagnant because of the hold harmless provision. As recently as 2016, 70 percent of enrollees di…
See more on retirable.com

Final Thoughts

  • Inflation is inevitable, but at least Social Security recipients know they’ll get a raise to compensate for it. Medicare premiums could increase, as well, though. Thanks to the hold harmless provision, Social Security recipients have the confidence of knowing they won’t lose money because premiums increased more than the cost of living. If you’re currently planning your retirement, a C…
See more on retirable.com

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