Notes
1. Premiums include both amounts withheld from Social Security benefits or other Federal payments and those paid directly to Part D plans.
"2. Includes, net of payments from States, all government transfers required to fund benefit payments, inflation rebates as specified under the Inflation Reduction Act of 2022, administrative expenses, and State expenses for making low-income eligibility determinations."
3. Payments from States with respect to the Federal assumption of Medicaid responsibility for drug expenditures for full-benefit dually eligible individuals.
"4. Includes payments to Part D plans, government subsidies under the Inflation Reduction Act, payments to retiree drug subsidy plans, payments to States for making low-income eligibility determinations, Part D drug premiums collected from beneficiaries, and transfers to Medicare Advantage plans and private drug plans. Includes amounts for the Transitional Assistance program of $0.4 billion, $1.0 billion, and $0.1 billion in 20042006, respectively."
"5. As noted in section III.D2, a new policy was developed in 2015 under which amounts from the Treasury are transferred into the Part D account 5 business days before the benefit payments to the plans, rather than on the day the benefit payments are duetypically the first business day of a monthas had previously been the case. Accordingly, the Part D account includes a balance at the end of the previous year that is more substantial than it would have been prior to implementation of the new policy. For 2021, 2022, and 2023, the balances were larger than in prior years because of delayed settlement of the year-end reconciliation amounts from November to January. In addition, the balances since 2019 have also included an accumulated reserve for the administrative costs incurred by SSA on behalf of Medicare."
"6. Section 708 of Title VII of the Social Security Act modifies the provisions for the delivery of Social Security benefit checks when the regularly designated delivery day falls on a Saturday, Sunday, or legal public holiday.  Delivery of benefit checks normally due January 3, 2010 occurred on December 31, 2009, delivery of benefit checks normally due January 3, 2016 occurred on December 31, 2015, and delivery of benefit checks normally due January 3, 2021 occurred on December 31, 2020. Consequently, the Part D premiums withheld from these benefits were added to the Part D account on December 31, 2009 (about $209 million), December 31, 2015 (about $184 million), and December 31, 2020 (about $137 million).  These premiums are excluded from the premium income for calendar year 2010, 2016, and 2021. "
"7. Section 708 of Title VII of the Social Security Act modifies the provisions for the delivery of Social Security benefit checks when the regularly designated delivery day falls on a Saturday, Sunday, or legal public holiday. The expected payment date for those benefits normally due January 3, 2027 is December 31, 2026. Accordingly, an estimated $0.1 billion will be added to the Part D account on December 31, 2026."
"8. Reflects a larger-than-usual downward adjustment in 2017 of $0.3 billion for prior?year allocations among Part A, Part B, and Part D"
Note: Totals do not necessarily equal the sums of rounded components.
























































