If you’re enrolled in Medicare Part B, a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, you may be subject to an Income-Related Monthly Adjustment Amount (IRMAA). Medicare Part B-IRMAA and Part D-IRMAA are added premiums you may have to pay if Social Security determines that your income from two years ago is above a specified threshold, in accordance with the Medicare Modernization Act (MMA) and the Affordable Care Act (ACA), respectively. According to the Social Security Administration (SSA), fewer than five percent of Medicare beneficiaries will pay the higher premium.
Do I have to pay a higher Medicare Part B and/or Part D premium?
If you’re enrolled in Original Medicare (Part A and Part B), or a Medicare plan that provides prescription drug coverage, your total premium amount depends on the earnings you report to the Internal Revenue Service (IRS). As of 2018, IRMAA applies to beneficiaries whose reported earnings two years ago were more than $85,000 per year for an individual and more than $170,000 per year for a married couple who file taxes jointly.
IRMAA is not the same as a late enrollment penalty. IRMAA is about the modified adjusted gross income you reported on your IRS tax return two years ago. At any point in time, if the SSA finds that your income level meets the IRMAA requirement, it will send you an Initial IRMAA Determination notice and set higher monthly premium payments for your Medicare Part B and Part D coverage. Be sure to keep that notice, because it includes important information about your appeal rights, if you disagree with SSA’s decision.
Remember, if you have a Medicare Supplement plan or a Medicare Advantage plan, you still have Medicare Part A and Part B. Therefore, if your earnings fall within the category described below, IRMAA may still apply to you because you are still responsible for the Part B premium. The Part B premium is in addition to the premium of the Medicare Supplement plan or Medicare Advantage plan, if any.
If you disagree with SSA’s determination — for example, if your income has dropped — you can file an appeal by filling out and sending this form to Social Security.
How much is my IRMAA amount?
The following chart gives you an idea of your estimated Medicare Part B-IRMAA and/or Part D-IRMAA costs if your total income in 2016 was over $85,000. (You don’t have to pay an extra amount with your monthly premium if your income was $85,000 or less.)
The Social Security Administration (SSA) uses your modified adjusted gross income (MAGI) as the basis for IRMAA determination in the chart below. Your MAGI is the total of your adjusted gross income and tax-exempt interest income.
|File individual tax return||File joint tax return||Married and file separate tax return||Part B monthly premium (in 2018)*||Part D monthly premium (in 2018)|
|$85,000 or less||$170,000 or less||Not Applicable||$134.00 (standard premium)||Your plan premium|
|Above $85,000, up to $107,000||Above $170,000, up to $214,000||Not Applicable||$187.50||$13.00 + your plan premium|
|Above $107,000, up to $133,500||Above $214,000, up to $267,000||Not Applicable||$267.90||$33.60 + your plan premium|
|Above $133,500, up to $160,000||Above $267,000, up to $320,000||Not Applicable||$348.30||$54.20 + your plan premium|
|Above $160,000||Above $320,000||Above $85,000||$428.60||$74.80 + your plan premium|
*Please note that your Medicare Part B premium may be less than shown in this chart; see Medicare.gov for details.
How do I pay the IRMAA amount?
It’s important for you to understand that IRMAA isn’t part of your regular Medicare Part B or your Part D monthly premium, and it’s paid differently.
The IRMAA amount is typically deducted from your monthly Social Security (SSA) payment. However, you will get a monthly bill (separate from your Medicare Part B or Part D premium) if any of the following is true for you:
- You don’t get monthly Social Security payments.
- The IRMAA amount is more than your monthly SSA payment.
- You get monthly benefits from the Railroad Retirement Board (RRB) instead of from SSA.
The bill will come from the appropriate government agency, such as the Centers for Medicare & Medicaid Services or the RRB. This is true even if a third party or your employer pays for your Medicare Part B or Part D monthly premium.
The Medicare IRMAA amount can change each year, and you’re required by law to pay that extra amount in order to keep your Medicare Part B and/or Part D coverage. If you fail to pay the Medicare IRMAA, you may be disenrolled from Medicare and lose your health insurance coverage permanently.
To keep your Medicare benefits running smoothly and simply, you might want to:
- Pay your Medicare Part B-IRMAA and/or Medicare Part D-IRMAA bill to Medicare as soon as you get it.
- Make sure the SSA always has your current address, even if you don’t get Social Security benefits.
- Sign up for Medicare Easy Pay at this medicare.gov page.
For more information on the Medicare IRMAA, call Social Security at 1-800-772-1213 (TTY users call 1-800-325-0778) from 7AM to 7PM Monday through Friday ET.