The Medicare hold harmless provision prevents a recipient's Social Security benefits from being reduced due to Medicare Part B premiums. People who pay Part B premiums directly to Medicare—or who have premiums paid by Medicaid
Medicaid
Medicaid in the United States is a federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The Health Insurance As…
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 is the hold harmless rule for Social Security?
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.
Does hold harmless apply to Medicare Part B?
The hold harmless provision does NOT protect you if: You are new to Medicare. 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).
Does hold harmless apply to me?
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 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 a hold harmless provision?
If Medicare premiums increase, a hold harmless provision protects recipients to ensure that any cost of living adjustment won’t be wiped out.
When do Medicare Part B premiums have to be deducted from Social Security?
Medicare Part B premiums must have been deducted from your Social Security income from November to January.
Is COLA good for Social Security?
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.
Does Medicare Part B have a hold harmless provision?
But the hold harmless provision does have some exceptions. If you’re receiving Social Security benefits and paying premiums for Medicare Part B, it’s important to know how premium increases may affect your Social Security income.
Does Medicare wipe out Social Security?
The government also has protections in place to ensure your Social Security Part B premium increase under Medicare doesn’t wipe out your Social Security payment increase.
Did Medicare see a rate increase in 2016?
As recently as 2016, 70 percent of enrollees didn’t see the Medicare rate hike because of the provision. But that doesn’t stop Medicare from boosting premiums to offset the loss. Those hikes may be paid by the people who aren’t protected by the provision or made up in future years, when COLA allows Social Security payments to begin outpacing the rise in Medicare premiums once again.
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.
Who is held harmless on Social Security?
The hold harmless rule applies to all Social Security recipients except the wealthy (defined as those earning $85,000 for an individual or $170,000 for a married couple) and those who are receiving Medicare for the first year. 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.
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.
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 ...
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.
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.
Explore your payment options
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.
What is the hold harmless provision for Medicare?
This is called the “hold harmless” provision, and it protects about 70 percent of Medicare beneficiaries from having to pay the full amount of the Part B premium increase in years when the COLA wouldn’t be enough to cover the premium hike.
What is a hold harmless policy?
A: A policy known as the “hold harmless” provision protects many Medicare beneficiaries by essentially capping Medicare Part B premiums so increases aren’t higher than Social Security’s Cost of Living Adjustment (COLA).
What percentage of Medicare Part B will receive COLA?
The federal government estimated that only about 3.5 percent of Medicare Part B enrollees would receive COLAs that still weren’t sufficient to cover the full increase in their Part B premiums, and would thus still be paying less than the standard premium in 2019. For 2018, the Social Security COLA was 2 percent.
What was the Medicare premium for 2016?
For 2016, the standard Medicare Part B premium was $121.80/month. But about 70 percent of enrollees were only paying $104.90 (the same rate they paid in 2015), because they were “held harmless” from the rate hike in 2016.
How much did Medicare pay in 2017?
For 2017, the provision meant that the 10 percent rate increase for that year (from $121.80/month to $134/month) only applied to about 30 percent of Medicare enrollees. The other 70 percent paid about $109/month (up from $104.90/month in 2016).
Does Medicare pay Social Security?
Most Medicare beneficiaries are also receiving Social Security benefits, and their Part B premiums are automatically deducted from their Social Security checks. Social Security benefits also tend to increase over time due to the Cost of Living Adjustment (COLA). But sometimes the Medicare Part B premium increase is larger than the Social Security COLA. In that situation, the result would be a decrease in net Social Security checks from one year to the next (for example, if the COLA only adds $5/month to a person’s check but their Part B premiums go up by $8/month, their net Social Security check would be $3/month smaller in the second year).
Is Cola enough for Part B?
By 2019, however, the COLA was sufficient to allow nearly all Part B enrollees to pay the standard amount for their coverage, without experiencing a drop in their net Social Security checks.
Why is the hold harmless provision important?
The hold-harmless provision is a key tool to prevent financial hardship for Social Security recipients on Medicare. But it doesn't work as well as many people think it should. Unfortunately, limiting Medicare premium increases to the percentage rate of Social Security COLAs would be a lot more burdensome on Medicare's financial viability, and so it's unlikely that retirees will see any changes in that direction in the near future.
How does Social Security work with Medicare?
One of the most important ways that Social Security and Medicare work together is in preventing Social Security recipients from suffering financial harm as a result of Medicare increases. A key rule known as the hold-harmless provision helps to ensure that Social Security recipients won't face painful reductions in their monthly benefits even when costs under Medicare are on the rise. However, the way that the hold-harmless provision works doesn't quite match up with the mistaken ideas that many recipients have about how it should work. It's essential to know the facts so that you can avoid any nasty surprises during your retired years.
What is the role of Social Security and Medicare?
Together, Social Security and Medicare aim to give retirees vital assistance with their medical and financial obligations. The Centers for Medicare and Medicaid Services, or CMS, cooperate and work together with the Social Security Administration, or SSA, in a variety of ways to ensure that the two programs work as smoothly as possible.
Does Medicare have to be deposited into Social Security?
That way, you don't have to worry about the SSA making a deposit to your account at the same time the CMS is trying to draw from the same account.
Is Medicare premium higher than Social Security?
During some years, the increase in monthly charges for Medicare premiums has been higher than the boost in monthly benefit amounts for Social Security recipients. Those who rely on Social Security would have to deal with the prospect of seeing an outright decline in their net monthly checks during such periods.
Does Motley Fool have a disclosure policy?
The Motley Fool has a disclosure policy.
Does Medicare hold harmless increase your premiums?
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. For instance, in 2014, Medicare costs stayed at $104.90, but Social Security COLAs came in at 1.5%. Even for our $200 benefit recipient in the example above, that would've been enough to push their premium costs all the way up to the full $104.90 amount.
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.
Does COLA cover Part B?
The COLA in 2020 is likely to cover the full Part B premium for most people. If your COLA is large enough to cover the full amount of your increased premium, you will not be held harmless and your premium will increase to $144.60. The hold harmless provision does NOT protect you if: You are new to Medicare in 2020.
What happens if you are covered by Hold Harmless?
Now, if you were covered by the Hold Harmless provision, your premium would have stayed the same. That means that your net Social Security benefit remains unchanged.
What is the hold harmless amount for 2020?
For 2020, that threshold is $87,000 for single individuals and $174,000 for those who are married filing jointly. This means that if your 2020 income were to surpass that threshold amount, you would not be protected by the hold harmless provision in 2022.
How much did Medicare premiums increase in 2016?
That increase had to be carried by those who were not protected by the Hold Harmless provision. The result was a 14.6% increase in Medicare premiums. Just a few years later in 2015, this topic came up again because the early forecast for the 2016 Part B premiums were looking for a 52% increase, which would have been $55 a month for those who are not held harmless.
What happens if you have a large increase in insurance premiums?
So if you have a year with a large increase in premiums, and a majority of beneficiaries are held harmless, those who are not held harmless would have to pay a disproportionate share of that increase.
Do you get Medicare if you are 65?
If you are 65 and on Social Security, your Medicare Part B premiums are automatically deducted from your benefits check before it ever arrives into your account. If you’re 65 and not drawing Social Security, you probably receive a quarterly bill (and if not, then it’s monthly) for Medicare.
Does Hold Harmless reduce Medicare premiums?
But the other thing to remember about the Hold Harmless provision is that it doesn’t permanently reduce your monthly Medicare premiums.
Can Social Security decrease due to Part B premiums?
The Hold Harmless provision says that the net amount of a Social Security check cannot decrease due to rising Part B premiums.
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....
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…
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…
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…