Gardiner urges state to increase income threshold for Medicare Part B


The premium bills for Medicare Part B beneficiaries might not sound like they’d break the bank, but for seniors on fixed incomes, it can make a big difference. That’s why Elmer Gardiner, a 77-year-old resident of Warwick, is on a crusade to see the income threshold increased in Rhode Island.

The Centers for Medicare and Medicaid Services (CMS) set a baseline income requirement in order for Part B premiums to be covered. That minimum is roughly 135 percent of the poverty level, which, in Rhode Island, means that beneficiaries who earn $1,257 or less per month are eligible to have their premiums covered. Beyond that, the premiums go up. Gardiner pays $99.90 per month for his coverage.

At one time, beneficiaries paid the same monthly premium for Part B. The Medicare Modernization Act of 2003 established an income-related premium, though, and higher-income beneficiaries began paying a bigger share once that act went into effect in 2007.

According to the Henry J. Kaiser Family Foundation, by 2019, the HHS Office of the Actuary projects income-related Part B premium amounts will range from $224 to $512 per month. The Affordable Care Act will not impact Medicare Savings Programs, however, according to Helen Mulligan from CMS.

Gardiner believes the current income figure is too low, and wants the state to intervene. While CMS sets the minimum, states have the flexibility in their plans to increase the threshold.

“The states have the option to increase that. By Rhode Island having a low threshold, we’re not getting the federal dollars out of Social Security that other states are getting,” Gardiner said.

Plan B premiums are paid through the Medicare Savings Plan. The federal government pays 52 percent, with the remaining 48 percent covered by the state.

Several nearby states have increased the threshold, as Gardiner suggests, including Maine and Connecticut. Maine pays 185 percent of the federal poverty level (FPL), which, for an individual, translates to $1,723 per month. Connecticut goes even further, covering 248 percent of the FPL – an income cap of $2,308, or nearly double what Rhode Islanders can earn.

A representative from CMS said that the Maine and Connecticut figures are not the norm, necessarily, and estimated that some 80 percent of states and territories stayed close to the minimum.

Even bringing the Ocean State into the $1,700 range would be a step in the right direction, Gardiner said.

“At least it would be an improvement,” he said.

Rhode Island did increase the threshold not long ago, up from $1,226, but that $31 means little to Gardiner.

“It’s still far under where it should be,” he said.

Gardiner has the support of both The Wiley Center and the Senior Agenda Coalition on increasing the threshold.

“I know 100 bucks a month is not big money, but it’s a help to people who are struggling. It gives them dignity; it lets them maybe go out to lunch once a month, just to get out of the house,” he continued, adding that with the rising cost of food, gas and home heating oil, seniors’ fixed incomes are already being stretched thin.

Gardiner urged his fellow Plan B beneficiaries to call their legislators and write letters to the state Department of Health and Human Services. A spokesman for that department said they were unsure of whom in the department would even handle the issue.

The Department of Elderly Affairs, while they advocate for seniors, does not have an influence over the issue and spokesman Larry Grimaldi said he did not know of any lobbying efforts being made to increase the threshold at this time.


No comments on this story | Please log in to comment by clicking here
Please log in or register to add your comment