IRMAA Rules for Medicare Part B and Part D Premiums

The standard premium for Medicare Part B is $135.50 in 2019.1 However, some people may receive a bill for more than that amount along with an IRMAA (Income-Related Monthly Adjustment Amount) notice.

What is IRMAA and how might it affect your Medicare costs?

Man doing his finances

What is IRMAA?

IRMAA represents the additional amount that some people might have to pay for their Medicare Part B (medical insurance) or Part D (Medicare prescription drug plans) coverage.

Medicare beneficiaries who have to pay a higher monthly premium for their benefits because of IRMAA must do so because they are categorized as a higher income earner.

How is IRMAA calculated?

Your Medicare Part B and Part D premiums are based on your modified adjusted gross income (MAGI) that is reported on your IRS tax return from two years prior. For example, your 2019 Medicare Part B premiums will be based on your reported income from 2017.

If your MAGI is $85,000 or less when filed individually (or married and filing separately), or $170,000 or less when filed jointly, you will pay the standard Part B premium of $135.50 per month in 2019, and you won’t pay a Part B IRMAA.

If you are enrolled in a Part D plan and your MAGI is in the above range, you would pay only the standard premium cost of your Part D plan in 2019, and you won’t pay a Part D IRMAA.2

But if your modified adjusted gross income from 2017 is more than those amounts, you will pay more than the standard Part B and Part D premiums in 2019, because you will pay an IRMAA.

The full breakdown is as follows:

Medicare Part B & Part D IRMAA

2017 Individual tax return

2017 Joint tax return

2017 Married and separate tax return

2019 Part B premium

2019 Part D premium

$85,000 or less

$170,000 or less

$85,000 or less

$135.50

Your plan premium

More than $85,000 and up to $107,000

More than $170,000 and up to $214,000

N/A

$189.60

You plan premium + $12.40

More than $107,000 up to $133,500

More than $214,000 up to $267,000

N/A

$270.90

Your plan premium + $31.90

More than $133,500 up to $160,000

More than $267,000 up to $320,000

N/A

$352.20

Your plan premium + $51.40

More than $160,000 up to $500,000

More than $320,000 up to $750,000

More than $85,000 up to $415,000

$433.40

Your plan premium + $70.90

More $500,000

More than $750,000

More than $415,000

$460.50

Your plan premium + $77.40

You will also generally pay the standard Part B premium if:

  • You enrolled in Part B for the first time in 2019
  • You do not receive Social Security benefits
  • You receive Social Security benefits, but your Part B premiums are not directly deducted from your Social Security benefits

*If you are subject to a Part D IRMAA, you may be able to save money by enrolling in a Medicare Advantage plan that includes prescription drug coverage.

Because IRMAA is based on your reported income from two years prior, the amount you have to pay for a Medicare IRMAA is subject to change every year.

Why is there a Medicare IRMAA?

If you’re among the people paying more for Part B or Part D Medicare coverage because of IRMAA, you may be wondering why the adjusted amounts exist.

IRMAA was enacted for Medicare Part B premiums in 2003 as a provision of the Medicare Modernization Act. It was then expanded to Part D coverage in 2011 as part of the Affordable Care Act (ACA, also called Obamacare).

IRMAA was developed by the federal government as a means of strengthening the financial stability of the Medicare program. The government pays a majority share (around 75 percent) of the costs for Part B and Part D benefits, while beneficiaries contribute roughly 25 percent.

With the future of Medicare on uncertain ground, cost-sharing measures like IRMAA have the potential to help prolong the financial stability of the largest health care program for seniors in the U.S.

If you are subject to paying higher Medicare premiums because of IRMAA, you will be notified by the Social Security Administration.

What are my Medicare plan options?

Have more questions about IRMAA or other costs associated with Medicare? Looking for ways to save money on your Medicare coverage?

You can learn more about your Medicare plan options and find a plan that may be able to help you save money. Speak with a licensed insurance agent to find out more by calling TTY Users: 711 24 hours a day, 7 days a week.

 

1 Medicare.gov. Medicare 2019 costs at a glance. Retrieved from www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html.

2 Medicare.gov. Monthly premium for drug plans. Retrieved from www.medicare.gov/part-d/costs/premiums/drug-plan-premiums.html.

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