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Tuesday, January 4, 2011

2011 Gift Penalty Factor

Kentucky's Transfer Resource Factor (TRF) for 2011 is $5,820.  This is the number used to calculate the penalty for transfers of assets for less than fair market value, otherwise known as gifts.  If a parent gifts a child a $100,000 house and then applies for Medicaid, there will be a 17 month period of ineligibility for Medicaid due to that gift (100,000 / 5,820 = 17.18213).


Tuesday, January 4, 2011

Advocate for KY Elderly Suggests 1% Sales Tax Increase to Fund Senior Services

An advocate for elderly people in nursing homes is calling on Kentucky lawmakers to create an “Elder Tax” to better fund services for the elderly.  Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, said a 1 percent increase in the state’s 6 percent sales tax could generate as much as $500 million a year that could go to such services.  Vonderheide acknowledged that getting lawmakers to approve a tax increase is unlikely. But he said articles in the state’s two largest newspapers last year make it clear the state is poorly prepared to address the needs of its rapidly aging population.

“There’s a crisis building here, and something bold needs to be done,” he said. “Politicians may run in the other direction but someone needs to take action.”  Vonderheide cited a December Courier-Journal series that reported state funding for elder services has been slashed in recent years, even as reports of adult abuse and neglect are rising and an increasing number of elderly citizens are believed to be at risk.
He also cited a Lexington Herald-Leader series earlier last year that reported on problems of abuse and neglect at nursing homes and the failure of officials to coordinate investigations and prosecute in some cases.  The common thread in the stories, Vonderheide said, “is there is no money in state coffers to solve the problems.”

Vonderheide outlined his idea for the sales tax increase in a Dec. 27 letter to Gov. Steve Beshear, asking him to lead the effort to win its approval.  But Beshear spokeswoman Kerri Richardson said the governor cannot support the idea.  “While Gov. Beshear understands the request for greater services for the elderly, he is strongly against raising any broad-based taxes on Kentucky families while we are in the midst of the worst economic recession of our lifetimes,” she said. “However, even in these tough times the governor will continue to look for ways to address some of these issues.”

Rep. Jim Wayne, D-Louisville, said he commends Vonderheide for raising the issue. But he said the state should consider an update of its entire tax system to increase revenue for senior citizens' programs and other human services.  “I'm always concerned about wanting to raise the sales tax,” he said. “It adds to the burden of the poor and the working people.”

Other officials have said it’s unlikely that anything requiring additional funding will get approval in the legislative session that began Tuesday.  Vonderheide said he’s not discouraged about the lack of enthusiasm for his proposal, even if nothing gets done this year.  “This could be part of the 2012 agenda,” he said. “But we’d better start taking about it right now.” 
 
Vonderheide said he’s especially concerned about cuts to the state’s Department of Aging and Independent Living, which helps fund services such as Meals on Wheels, housekeeping and personal care. Those programs allow the elderly to remain in their homes at much lower cost than in a nursing home.  That department has been cut by about $6 million since 2008, causing waiting lists to grow to more than 25,000 people. Meanwhile, projections are that nearly a quarter of the state’s residents will be 60 or older by 2030, meaning an increasing number of people will be in need, Vonderheide said.  “Why not get ahead of this challenging problem and act to solve it before it gets out of hand?” he asked in his letter to Beshear.
 
Courtesy Courier-Journal (1/4/2011 online article).

Friday, December 31, 2010

10 KY Nursing Homes Using Music to Cure Bedsores

Bedsores can be a serious problem for the elderly, but a University of Cincinnati study aims to curb them at Kentucky nursing homes with the help of music.  Every two hours, music plays over a loudspeaker, prompting caregivers to stop what they’re doing and make sure residents are re-positioned to keep bedsores from forming.

Researchers are partnering with Signature HealthCARE of Florida to conduct the study at 10 of the company’s Kentucky homes, including two in Louisville.  “We love it,” said Kelly Thompson, administrator of Signature HealthCARE of East Louisville, which is part of the study group.  “They let you pick your music … and everybody knows it’s time for moving.”

“Repositioning people is not something new; what’s new is the prompt,” said Pam Larimore-Skinner, director of nursing at Signature HealthCARE of Trimble County in Bedford, Ky., which also is participating. “I think it makes people more conscious of the two hours because time can get away from you.”

Bedsores, also called pressure sores or pressure ulcers, are damaged areas of skin caused by staying in one position too long.  People who are bedridden or use wheelchairs are at greater risk for these sores, which can lead to serious infections that can even be life-threatening.  The problem is on the rise nationally.  Medical guidelines say patients should be moved at least every two hours.  But nationally, “we know that the compliance of staff is frequently not what we want it to be,” said Elaine Miller, a UC nursing professor.

Researchers from the UC College of Nursing got a two-year, $300,000 grant from the Robert Wood Johnson Foundation to look at whether a simple audio reminder can prompt a nurse-led team to make sure patients move or get moved.  The Cincinnati team competed with more than 100 other applicants for the funds.  In the study, four nursing homes used the program since the spring, while another four “comparison” homes were observed for months, then began using the program in November.  Two others had problems with intercoms and have been used as comparisons throughout.

“The study involves the ambulatory residents, who can get up themselves, and the bedridden, who need to be turned with the assistance of staff,” said Assistant Professor Tracey Yap, principal investigator on the study.  “The musical prompt is a reminder for patients that ‘you need to get up’ and for staff that this is the time to move those who cannot do so themselves.”

Local nursing home officials said their entire staffs are involved in the project, from nurses to administrators to housekeeping workers.  Anyone who needs hands-on assistance gets help from the nursing staff, Yap said, while other employees can give verbal reminders to those who don’t need such help.  “It’s a team project,” Yap said. “That’s the innovative part of it.”

Officials said they vary the music so it doesn’t get repetitive or easy to tune out. Larimore-Skinner said her nursing home has played small bursts of everything from classical to country to holiday music.  Thompson and Larimore-Skinner said their facilities are doing well when it comes to pressure sores, and the study program may be one reason.  Larimore-Skinner said none of her 49 residents have developed sores in the home, and Thompson said her facility, which has 115 residents, does better than the national average on pressure sores.  Both women said their homes may continue the practice after the study ends in April.  “If it works,” Larimore-Skinner said, “don’t fix what’s not broken.”

 

Courtesy Courier-Journal


Thursday, December 30, 2010

Louisville Metro's 2011 Senior Social & Sports Calendar

Metro Parks Senior Services offers a variety of social and athletic programs for senior citizens, including dances and card games. The Senior Services staff also conducts the annual Fifty and Over Games, and provides programs for senior citizens in the Kentucky State Fair's Heritage Hall.

Metro Parks Senior Services can be reached at 502-574-2646.  Also, you can get more information at their website: http://www.louisvilleky.gov/MetroParks/recreation/seniors.htm

 

2011 Senior Social & Sports Calendar

January 26th: Winter Corntoss Tournament at Fairdale Playtorium

February 9th: “Hugs” Senior Valentine Party at Portland C.C.

February 23rd: “Great Balls of Fire” Billiards tournament at Beechmont CC

March 1st – 4th: “FunFest” Senior Celebration. Dance & activities all week at Sun Valley CC.

March 23rd: “Spring Fling & Style Show” at Newburg CC

April 7th: Metro 50 & over basketball league begins

April 11th: Sign-ups begin for the “50 & Over Games” begins

May 14th – 22nd: Metro Parks & Recreation 50 & Over Games

June 8th: Senior Picnic (Farnsley Moreman or Locust Grove)

June 22nd: Summer Corntoss Tournament at Fairdale Playtorium

July 6th -27th: Metro Mini Bowling at Walnut Street (Call for exact dates)

August 18th – 28th: State Fair month and Heritage Hall for Seniors

September 7th -28th: Senior Archery classes at Douglass CC gym

October 12th: South Louisville CC Senior Social

November 9th: Chili Sampling at the Forest

November 30th: Winter Corntoss Tournament at Fairdale Playtorium

December 14th: Holiday Dance & Fun at Sun Valley CC

 

Individuals must register for these programs at least one week prior to event through Metro Parks & Recreation Senior Services office by calling 574-2646.  Some programs fill up quickly! First come – First served!!

 

December 16: Holiday Dance and Fun at Sun Valley. Must register by Dec. 9!

 

 

 

Bold items indicate highly recommended programs to call early about!

 

 

*all program participants must register at least one week prior to event through the Metro Parks Senior Services Office at 574.2646.

 


Thursday, December 30, 2010

Summary of Trustee Duties

A trust is a legal arrangement through which one person (or an institution, such as a bank or law firm), called a "trustee," holds legal title to property for another person, called a "beneficiary." If you have been appointed the trustee of a trust, this is a strong vote of confidence in your judgment and probity. Unfortunately, it is also a major responsibility. Following is a very brief overview of some of your duties:

1.     Fiduciary Responsibility. As a trustee, you stand in a "fiduciary" role with respect to the beneficiaries of the trust, both the current beneficiaries and any "remaindermen" named to receive trust assets upon the death of those entitled to income or principal now. As a fiduciary, you will be held to a very high standard, meaning that you must pay even more attention to the trust investments and disbursements than you would for your own accounts.

 2.     The Trust's Terms. Read the trust itself carefully, both now and when any questions arise. The trust is your road map and you must follow its directions, whether about when and how to distribute income and principal or what reports you need to make to beneficiaries.

 3.     Investment Standards. Your investments must be prudent, meaning that you cannot place money in speculative or risky investments. In addition, your investments must take into account the interests of both current and future beneficiaries. For instance, you may have a current beneficiary who is entitled to income from the trust. He or she would be best off in most cases if you invested the trust funds to generate as much income as possible. However, this may be detrimental to the interest of later beneficiaries who would be happiest if you invested for growth. In addition to balancing the interests of the various beneficiaries, you must consider their future financial needs. Does a trust beneficiary anticipate buying a house or going to school? Will she be depending on the trust income for retirement in 15 years? All of these questions need to be considered in determining an investment plan for the trust. Only then can you start considering the propriety of individual investments.

 4.     Distributions. Where you have discretion on whether or not to make distributions to a beneficiary you need to evaluate his current needs, his future needs, his other sources of income, and your responsibilities to other beneficiaries before making a decision. And all of these considerations must be made in light of the size of the trust. Often the most important role of a trustee is the ability to say "no" and set limits on the use of the trust assets. This can be difficult when the need for current assistance is readily apparent.

 5.     Accounting. One of your jobs as trustee is to keep track of all income to, distributions from, and expenditures by the trust. Generally, you must give an account of this information to the beneficiaries on an annual basis, though you need to check the terms of the trust to be sure. In strict trust accounting, you must keep track of and report on principal and income separately.

 6.     Taxes. Depending on whether the trust is revocable or irrevocable and whether it is considered a "grantor" trust for tax purposes, the trustee will have to file an annual tax return and may have to pay taxes. In many cases, the trust will act as a pass through with the income being taxed to the beneficiary. In any event, if you keep good records and turn this over to an accountant to prepare, this should not be a big problem.

 7.     Delegation. While you cannot delegate your responsibility as trustee, you can delegate all of the functions described above. You can hire financial advisors to make investments, accountants to handle taxes and bookkeeping for the trust, and lawyers to advise you on questions of interpretation. With such professional assistance, the job of trustee need not be difficult. However, you still need to communicate with those you hire and make any discretionary decisions, such as when to make distributions of principal from the trust to one or more beneficiaries.

 8.     Fees. Trustees are entitled to reasonable fees for their services. Family members often do not accept fees, though that can depend on the work involved in a particular case, the relationship of the family member, and whether the family member trustee has been chosen due to his or her professional expertise. Determining what is reasonable can be difficult. Banks, trust companies, and law firms typically charge a percentage of the funds under management. Others may charge for their time. In general, what's reasonable depends on the work involved, the amount of funds in the trust, other expenses paid out by the trust, the professional experience of the trustee, and the overall expenses for administering the trust. For instance, if the trustee has hired an outside firm for investment purposes, that expense would argue for the trustee taking a somewhat smaller fee. In any case, it makes sense to consult with a professional experienced with trust work who can guide you on what would be normal fees considering all of the circumstances.

In short, acting as trustee gives you a wonderful opportunity to provide a great service to the trust's beneficiaries. The work can be very gratifying. Just keep an eye on the responsibilities described above to make sure everything is in order so no one has grounds to question your actions at a later date.


Tuesday, December 21, 2010

How to Recognize Elder Abuse

ElderServe, a nonprofit Louisville agency that provides services to older adults, offers the following tips on what to look for to recognize abuse, neglect or exploitation. It calls the list its “Speak Up for Seniors!” guide:

Sudden changes in behavior or finances.
Physical injuries, dehydration or malnourishment.
Extreme withdrawal, depression or anxiety.
Absence of basic care or necessities.
Kept away from others.
Unsanitary living conditions.
Personal items missing.

For more information, contact ElderServe at (502) 587-8673 or www.elderserveinc.org.


Tuesday, December 21, 2010

Long-Term Care "Conversation Checklist" For Families

Having a conversation about long-term care with an aging loved one can be difficult. Initiating a conversation can be awkward or uncomfortable for family members or caregivers. Although it is impossible to know what the future will bring, SNAPforSeniors, a national database for senior housing, offers the following hints and checklist that may help to begin a conversation about housing options with your loved one.

1. Determine if it’s time to think about long term care facilities.

Reasons to seek long-term care vary from person to person. In addition to potentially offering a more comfortable and safer environment for the aging loved one, long-term care may be necessary for the mental and physical health of the caregiver.

To ensure your loved one is able to contribute to his/her future, introduce alternate housing options as early as possible, even before necessary. Ask your loved one questions about lifestyle or health-related challenges. Continue the conversation over time by sharing your observations and concerns, including any of the following physical and mental symptoms:

Physical Symptoms
• Are they able to move around easily given the physical layout of the home? For example, are stairs, carpet, bath/shower or door handles obstacles for mobility? Is the heating and lighting adequate for any sensory impairments including hearing, sight and circulation problems?
• Are they experiencing balance issues, especially when changing positions? Are you concerned about them falling?
• If they fell, are you confident he or she would be able to call for help? Is there a reliable source to respond to a call at all times?
• Is your loved one repeatedly complaining of physical aches and pains?
• Are they experiencing frequent incontinence? Can they attend to the problem when this happens or is help needed?
• Do they have difficulty dressing, bathing or with personal hygiene such as hair and foot care?
• Is your loved one experiencing frequent, significant sleep disturbances?
• Are they capable of cooking or preparing healthy meals?
• Have operating gadgets or appliances such as the can opener, stove or telephone become difficult?
• Have household chores become a burden? Is vacuuming, sweeping, taking out the garbage, cleaning the dishes or bathroom being done in timely ways?
• Are finances such as bill payment, deposits, and investments being handled in a timely manner?
• Is your loved one still driving? If so, are you concerned about his/her and others wellbeing? Is public transportation a safe and viable option?
• Are prescribed medications obtained and taken as indicated consistently?
Mental Symptoms:
• Is your loved one demonstrating personality changes, including but not limited to:
• Frequent irritability?
• Insensitivity to others?
• Disoriented to place and time?
• Aggressive behaviors?
• Repetitive behaviors?
• Communicating with inappropriate language?
• Is your loved one socially withdrawn and not able or not wanting to get together with friends or family? Are there signs of depression?
• Do they express negative comments about him or herself?
• Are they demonstrating an inability to make decisions or making poor decisions?
• Is your loved one able to understand communication or instructions from others?

2. Schedule a family meeting.

A family meeting can move the topic of long-term care to a more focused discussion that can lead to a plan. Here is a checklist for planning your family meeting:
• Determine the family members that should be involved directly or indirectly in decision making. This may include extended family members, close friends or paid caregivers. Always include the person if he/she is capable of taking part in any decision making.
• Consider including an independent third party to play the role of mediator. This could be a minister or other member of the clergy, a social worker or case manager.
• If necessary, find a neutral place to hold the meeting.
• Prepare an agenda to help you stay focused. It may include:

• A medical update
• Sharing of feelings about the illness and caregiving
• Daily caregiving needs
• Financial concerns
• Who will make decisions
• What support role each person will play
• What support the primary caregiver needs
• Next steps moving forward

3. Continue to involve family.

The move to a long-term care facility is an immense transition for any family, so it’s important to involve everyone relevant to the person:
• Reach out to siblings to secure their input and support. For example, share online information about long-term care facilities to secure greater involvement and participation.
• Is there is an unequal financial or time burden to one family member? If so, acknowledge the distribution of resources and discuss a strategy for achieving a balance that appeals to everyone.

4. Continue to engage your parent or loved one.

• Have ongoing conversations at times when your loved one is feeling best and there are few distractions.
• Introduce the idea of an overnight visit to a long-term care facility or an extended afternoon visit to get a feel for the various available options.

5. Begin researching long-term care options in your area.

• Go to snapforseniors.com to access a nationwide senior housing database.
• Enter your city, state, zip, county or address and begin researching options by category of housing.
• View the listing details or contact the facility to ask questions and schedule a site visit.
• Read comments from consumers on the listing if available.
• Ask the facility you visit for a copy of their last annual licensing survey report.
• Contact your local senior ombudsman to get perspective from a local trusted resource.
• Check references from existing or prior residents or families.


Monday, December 20, 2010

IRS Issues Long-Term Care Premium Deductibility Limits for 2011

Social Security benefits may be stagnant, but the IRS is increasing the amount you can deduct on your 2011 taxes as a result of buying long-term care insurance.

Premiums for "qualified" long-term care insurance policies (see explanation below) are tax deductible provided that they, along with other unreimbursed medical expenses, exceed 7.5 percent of the insured's adjusted gross income. These premiums -- what the policyholder pays the insurance company to keep the policy in force -- are deductible for the taxpayer, his or her spouse and other dependents. (If you are self-employed, the tax-deductibility rules are a little different: You can take the amount of the premium as a deduction as long as you made a net profit; your medical expenses do not have to exceed 7.5 percent of your income.)

However, there is a limit on how large a premium can be deducted, depending on the age of the taxpayer at the end of the year. Following are the deductibility limits for 2011. Any premium amounts for the year above these limits are not considered to be a medical expense.

Attained age before the close of the taxable year

Maximum deduction for year

40 or less

$340

More than 40 but not more than 50

$640

More than 50 but not more than 60

$1,270

More than 60 but not more than 70

$3,390

More than 70

$4,240

What Is a "Qualified" Policy?

To be "qualified," policies issued on or after January 1, 1997, must adhere to certain requirements, among them that the policy must offer the consumer the options of "inflation" and "nonforfeiture" protection, although the consumer can choose not to purchase these features. Policies purchased before January 1, 1997, will be grandfathered and treated as "qualified" as long as they have been approved by the insurance commissioner of the state in which they are sold.


Monday, December 20, 2010

Average Cost of a Nursing Home Room Tops $83,000 a Year

Nursing home and assisted living rates rose significantly from 2009 to 2010, according to the 2010 MetLife Market Survey of Long-Term Care Costs. Private room nursing home rates rose 4.6 percent to $83,585 a year or $229 a day, while assisted living facility costs climbed 5.2 percent on average to $39,516 a year or $3,293 a month.

The average cost of home health care aides and adult day care were unchanged, after having jumped about 5 percent the year before. Home care aides still average $21 per hour and adult day care services remain at an average $67 per day.

The survey also reports on the cost of a semi-private room in a nursing home, which increased 3.5 percent to $205 a day, or $74,825 a year. The cost of a semi-private room in an Alzheimer's wing actually dropped, from an average of $75,920 to an average of $75,190 annually.

Once again, the highest rates for a private nursing home room in 2010 were found in Alaska, where the cost is now $687 a day on average. The lowest rates were found in Louisiana (with the exception of Baton Rouge and the Shreveport area), at $138 a day.

The cost of assisted living was the highest in the Washington, D.C., area, at $5,231 a month and the lowest in Arkansas (except for Little Rock) at $2,073 a month. Average home health care aide services ranged from a high of $30 an hour in Rochester, Minnesota, to $14 and hour in the Shreveport area of Louisana. Adult day care services were highest in Vermont at an average of $140 a day and lowest in the Montgomery, Alabama, area, at $31 a day.

For the full 2010 report, including listings of average long-term care costs in selected cities, click here. (The report is available in PDF format. If you do not have the free PDF reader installed on your computer, download it here.)


Saturday, December 18, 2010

Obama Signs Tax-Cut Bill Setting Estate Tax Exemption at $5 Million for Two Years

Congress has passed and President Obama has signed into law the deal extending the Bush tax cuts that he struck with Congressional Republicans. The legislation restores the estate tax for two years at a 35 percent tax rate, with estates up to $5 million exempt from paying any tax ($10 million for couples). If Congress does not change the law in the interim, in 2013 the estate tax will revert to what it was scheduled to be in 2011 -- a 55 percent rate and a $1 million exemption. The $801 billion tax-cut bill makes several other significant changes to wealth transfer taxes:


•The new $5 million estate tax exemption and 35 percent rate are retroactive to January 1, 2010. The heirs of those dying in 2010 will have a choice between applying the new rules or electing to be covered under the rules that have applied in 2010 -- no estate tax but only a limited step-up in the cost basis of inherited assets. This will benefit the heirs of tens of thousands who died in 2010 with relatively modest estates and who would have been subject to capital gains tax on inherited assets above a certain threshold. (For more on this, click here.)

•The law makes the estate tax exemption "portable" between spouses. This means that if the first spouse to die does not use all of his or her $5 million exemption, the estate of the surviving spouse could use it.

•The law unifies the estate, gift and generation-skipping transfer tax exemptions at $5 million. (For 2010 there is no generation-skipping tax, while the gift tax exemption has been $1 million for a number of years.) A 35 percent tax rate will apply to gifts or transfers over the $5 million threshold. (There is no change in the $13,000 annual exclusion amount for gifts.) These high exemption levels mean that "[t]he rich will have a two-year window in 2011 and 2012 to protect huge amounts of their estates from taxation for generations," wrote estates attorney Kevin Staker on his Estate Tax News Blog.
But that window is open even wider than was previously assumed because of an additional loophole for the wealthy in the new law. Although taxpayers have until December 31, 2010, to transfer funds outright to grandchildren and avoid the generation-skipping tax, there's the risk that the grandkids will squander the sudden influx of cash. As Forbes blogger Janet Novak explains in a recent post, "the money doesn't (as most planners had believed) have to be distributed outright to the grandkids to qualify for the 0% rate. Instead, according to the fine print in the tax deal, it can be put in a trust for them, [noted estate planning lawyer Jonathan] Blattmachr says. That means, he explains, that money can be taken from an existing multigenerational trust, declared subject to the 2010 GST tax, and deposited in a new trust for grandkids' benefit, with the GST tax now pre-paid at a 0% rate." Novak says Blattmachr has been telling his estate planning attorney peers, "Cancel your ski trip or trip to Hawaii. This is a once-in-a-lifetime opportunity."

The generous estate tax provisions were the main sticking point for progressive Democrats. A vote in the House on an amendment to increase the estate tax, including lowering the exemption to $3.5 million, was defeated by a vote of 233 to 194. After some minor changes to the bill were made, it passed the House by a 277 to 148 margin, after having been approved overwhelmingly by the Senate 81 to 19.
The site Politico quotes one senior House Republican aide as saying, "I'm trying to remember something that we passed under Bush that was this good."

Tuesday, December 14, 2010

New Medicare Premium, Deductible and Co-Pay Charges for 2011

The basic premium for Medicare Part B will be $115.40 a month in 2011, up from $110.50 in 2010 (a 4.4 percent increase). But because there will be no cost of living benefit increase for Social Security recipients for 2011, most beneficiaries will be exempted from paying this increase and will instead pay the same $96.40 premium amount they have paid since 2008.

A "hold-harmless" provision in the Medicare law prohibits Part B premiums from rising more than that year's cost of living increase in Social Security benefits. Since there is no Social Security increase, most beneficiaries -- about 73 percent -- will not have to pay any increased Part B premiums because of the hold-harmless provision. Those covered by the provision will continue to pay Part B premiums of $96.40 per month in 2011.
 
But this hold-harmless protection does not apply to the other 27 percent of beneficiaries -- about 12 million in all -- who either:

•do not have their Part B premiums withheld from their Social Security checks, or
 
•pay a higher Part B premium surcharge based on high income (see below), or
 
•are newly enrolled in Part B.
 
All Medicare beneficiaries will be subject to the new deductibles and co-payments, as outlined below.  Medicare Part B covers physician services as well as qualifying out-patient hospital care, durable medical equipment, and certain home health services, among other services.
 
Following are all the new Medicare figures for 2011:

•Basic Part B premium: $115.40/month
 
•Part B deductible: $162 (was $155)
 
•Part A deductible: $1,132 (was $1,100)
 
•Co-payment for hospital stay days 61-90: $283/day (was $275)
 
•Co-payment for hospital stay days 91 and beyond: $566/day (was $550)
 
•Skilled nursing facility co-payment, days 21-100: $141.50/day (was $137.50)

As directed by the 2003 Medicare law, higher-income beneficiaries will pay higher Part B premiums.  Following are those amounts for 2011:
 
•Individuals with annual incomes between $85,000 and $107,000 and married couples with annual incomes between $170,000 and $214,000 will pay a monthly premium of $161.50.
 
•Individuals with annual incomes between $107,000 and $160,000 and married couples with annual incomes between $214,000 and $320,000 will pay a monthly premium of $230.70.
 
•Individuals with annual incomes between $160,000 and $214,000 and married couples with annual incomes between $320,000 and $428,000 will pay a monthly premium of $299.90.
 
•Individuals with annual incomes of $214,000 or more and married couples with annual incomes of $428,000 or more will pay a monthly premium of $369.10.
Rates differ for beneficiaries who are married but file a separate tax return from their spouse:
 
•Those with incomes between $85,000 and $129,000 will pay a monthly premium of $299.90.
 
•Those with incomes greater than $129,000 will pay a monthly premium of $369.10.

The Social Security Administration uses the income reported two years ago to determine a Part B beneficiary's premiums. So the income reported on a beneficiary's 2009 tax return is used to determine whether the beneficiary must pay a higher monthly Part B premium in 2011. Income is calculated by taking a beneficiary's adjusted gross income and adding back in some normally excluded income, such as tax-exempt interest, U.S. savings bond interest used to pay tuition, and certain income from foreign sources. This is called modified adjusted gross income (MAGI). If a beneficiary's MAGI decreased significantly in the past two years, she may request that information from more recent years be used to calculate the premium.

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