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November 12, 2021 06:59 PM

Medicare premiums will see big increase in 2022

Nona Tepper
Maya Goldman
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    Medicare members' monthly premiums for physician and outpatient services will increase nearly 15% in 2022, the Centers for Medicare and Medicaid Services said in a news release Friday.

    The agency attributed the increases to rising healthcare prices driven by COVID-19-related care, lawmakers' moves to lower 2021 premiums during the pandemic and the potential for pricey drugs like Biogen's Aduhelm to receive coverage.

    The standard monthly premium will rise to $170.10 in 2022, up 14.5% from $148.50 this year. The annual deductible will grow $233, up 14.7% from $203 in 2021. Enrollees will receive a 5.9% year-over-year cost of living adjustment through their Social Security benefits, which will more than cover the increase in Medicare Part B monthly premiums, the agency said. CMS said it was the largest cost of living increase in 30 years.

    Medicare premiums for hospital inpatient care will also go up in 2022, though CMS notes that about 99% of beneficiaries don't pay premiums for these services. Still, those who are subject to the costs will pay a $1,556 deductible if admitted to the hospital in 2022, an increase of $72 from $1,484 in 2021. Daily coinsurance rates for the 61st through 90th days of hospital care for a beneficiary, lifetime reserve days and skilled nursing facility stays will also increase in 2022.

    Another health plan targets dual-eligibles through Medicare Advantage-as-a-service

    "CMS is committed to ensuring high quality care and affordable coverage for those who rely on Medicare today, while protecting Medicare's sustainability for future generations," CMS Administrator Chiquita Brooks-LaSure said in a news release. "The increase in the Part B premiums for 2022 is continued evidence that rising drug costs threaten the affordability and sustainability of the Medicare program."

    Beneficiaries with Medicare drug coverage will see monthly premiums ranging from $0 to $77.90, based on their incomes.

    Lawmakers have eyed addressing prescription drug costs in the Build Back Better Act. Rep. Frank Pallone (D-N.J.), chair of the Energy and Commerce Committee, said rising Medicare premiums emphasizes the need for Congress to let Medicare negotiate those prices.

    "Skyrocketing drug prices not only make it harder for seniors to afford the lifesaving drugs they need, but also drive up their healthcare premiums for doctor's visits and outpatient care," Pallone said in a news release.

    Download Modern Healthcare’s app to stay informed when industry news breaks.

    Nearly 90% of consumers believe the federal government should negotiate directly with the drugmakers to drive down prices, according to a June poll by the Kaiser Family Foundation. Respondents across the political spectrum agreed that lowering prescription costs should be a key priority for President Joe Biden's administration.

    In June, the Food and Drug Administration approved the $56,000 intravenous drug aducanumab, marketed under the name Aduhelm, against the recommendations of FDA advisors that the agency reject drug manufacturer Biogen's application.

    The new Alzheimer's treatment is expected to comprise more than 1% of all national health spending by the mid-2020s, according to a report released earlier this year by not-for-profit research group Altarum. The drug will grow non-retail drug spending—therapies administered in hospitals or clinics—by at least 25%. U.S. prescription drug spending will jump at least 8% over the next few years, the report said.

    At least six Blue Cross Blue Shield affiliates have decided not to cover Aduhelm. For-profit insurers, like UnitedHealth Group, have said they are waiting to make coverage decisions based on the federal government's moves. Mount Sinai Health System and the Cleveland Clinic have said they will not prescribe the drug, citing concerns that it will not work.

    The 'Medicare Advantage-in-a-box' startup that runs on Amazon's cloud

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