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What is IRMAA for Medicare?

What is IRMAA

If you are one of the millions of aging Americans who receive Medicare Part D or Medicare Part B, chances are you may be familiar with the Income related monthly adjustment or IRMAA for Medicare.

Medicare Part D provides coverage for prescription medications, while Medicare Part B covers the cost of outpatient care and healthcare providers. Also covered under Medicare Plan B are home health care, medical equipment, and some preventative care services. 

If you have either of these plans, you could potentially have a monthly surcharge. The amount you are charged will ultimately depend upon your yearly income. This is called the IRMAA. 

Individuals with an annual income that is higher than a certain amount are required to pay this surcharge, which is over the amount you pay for Medicare Part B and Medicare Part D premiums. The Social Security Administration (SSA) decides who must pay an IRMAA. 

The amount you owe will be determined by the total amount you earn over a period of two years. In 2023, the SSA will examine your tax returns dating back to 2021. In 2023, the SSA will look at your tax returns from the past two years to determine if you need to pay an IRMAA. 

IRMAA is analyzed each year. If your income is higher or lower in any given year, the amount you owe, if any, will be adjusted. If the SSA determines that you must pay IRMAA, you will get a notice informing you of what your new premium will be and a reason why you are required to pay that amount.

A single individual who earns $97,000 or less each year will only have to pay his or her plan’s premium. The amount you pay will ultimately depend upon your situation. Part B premiums are typically higher for those who are married and filing jointly. Those who are married and filing jointly can pay as much as $428.60 for a Part B premium.

Those who are married and filing separately can expect to pay up to $560.60 for a Part B premium. But how do you pay for Part B and Part D IRMAA? According to Humana, your Part B IRMAA is added automatically to the bill with your monthly premium. 

There are four ways to pay this bill. If you have a secure Medicare account, you can pay online. You can also use your bank’s online bill pay system. You can also sign up for Medicare’s Easy Pay. You also have the option to send a check by mail to Medicare. The method you choose is a matter of preference, and sometimes paying online is a more convenient option.

A Part D IRMAA fee must be paid directly to Medicare, instead of to your employer or the plan you have. You are responsible for paying your IRMAA, “even if” a third party pays for your plan premiums. You will receive a bill from Medicare each month. You can pay your IRMAA in the same way you pay your Part B premiums.

However, there may be cases where you can file an appeal. According to experts, there may be cases where you don’t feel you should pay IRMAA. You can file an appeal if you believe that the SSA used outdated or incorrect tax information. You may also appeal an IRMAA if you’ve experienced a life change, such as the death of a spouse, a divorce, or marriage.

If a life-changing event reduces your yearly earnings, you may be able to appeal. 

You can file an appeal up to 60 days after receiving a notice. You can begin the appeal process by calling 1-800-772-1213. The amount you pay for IRMAA is determined by your income bracket and how you have filed taxes. 

The Internal Revenue Service (IRS) provides information about you to the SSA. You may receive a notice about the IRMAA at any time during a calendar year. If you receive a determination letter from the SSA, you will receive specific information. 

The notice you receive will tell you how IRMAA was determined, what to do if incorrect information was calculated IRMAA, and how to handle an income reduction resulting from a life-changing event. Twenty days or more after you receive a predetermination notice you will receive your initial determination notice. 

 Included in this notice is information about IRMAA, how you can appeal it, and when it goes into effect. If your income goes down, IRMAA fees may be removed. If your income goes up, you may be charged more. There is also the potential to owe IRMAA for the first time. 

Which parts of Medicare does IRMAA impact? According to experts, IRMAA does not impact Medicare Part A. Most people with Medicare Part A do not pay a monthly premium to have it. 

Medicare Part B covers outpatient health services, medical equipment, and certain types of preventative care. However, be aware that IRMAA adds a certain amount to your Part B monthly costs. The monthly premium for Plan B in 2022 was $170.10. An additional IRMAA surcharge may be added to your payment. 

If you have Medicare Part D, the company that issues the policy will decide how much you will pay as a monthly premium. If you decide to appeal an IRMAA determination, you should be aware of a few things. You will need to provide documentation proving that you deserve not to pay IRMAA costs.

You may need to provide federal income tax returns, a death certificate, marriage certificate, or notice of divorce or marital annulment. In addition, you may need to provide copies of your pay stubs, letters or statements proving you have stopped work or received a reduction in pay.

You may also need documentation proving the loss or reduction of a pension. According to Healthline, you may not even need to file an appeal. The SSA may perform another initial determination using updated information. If you are found ineligible for an updated evaluation, you may appeal this decision.

If you decide to file an appeal, the SSA can help you with that. The initial determination notice you receive will provide information on how to file an appeal. If your appeal is reviewed and approved, your monthly premiums may be adjusted. If your appeal is denied, the SSA can give you instructions for appealing the denial in a hearing. 

IRMAA was instituted in 2003 as a result of the Medicare Modernization Act. Although this rule applied only to individuals with high incomes, it acquired new rules under the Affordable Care Act. The new rules applied to high-income earners who were enrolled in Medicare Part D. 

IRMAA affects your Medicare in many ways. Because the government pays roughly 75 percent of your Part B coverage, you still must pay. You will need to pay a large amount to receive coverage. The larger amount you pay is your IRMAA. In addition to your IRMAA, you will have to pay a higher priced premium. 

IRMAA isn’t part of your plan’s premium, and what you pay is the amount you’re required to pay after Medicare has covered its share. When added together, both payments equal your plan’s premium. If you have more money than you are allowed to have, the government asks for an IRMAA. 

The government determines whether you are eligible for IRMAA by “calculating” what your modified adjusted gross income or MAGI is. Your monthly IRMAA is ultimately determined by your total income. MAGI is essentially an adjusted gross income (AGI), which has other costs factored into it. 

The SSA often uses your AGI to decide what your income bracket is. Used for tax purposes, your AGI is your total yearly income, with some deductions taken out. Your MAGI changes when you add some deductions back to it. But what deductions can be added back to your MAGI?

According to experts, IRA contributions, student loan interest, deductions for tuition and fees, and taxable social security payments can be added back to your MAGI. Additionally, your income has a huge impact on the price of your premiums. 

There are several different tiers when it comes to the cost of plan premiums. A Tier 1 individual typically has a MAGI with a cap of $97,000. Tier 1 plans also apply to married couples filing jointly. Married couples filing jointly typically have MAGIs that are $194,000 and below. 

IRMAA may be an inconvenience for some. However, it is a huge part of the Medicare system. Only people who are single and earn more than $97,000 and couples earning more than $194,000 per year must pay IRMAA.    

6 Sources

MedigapCoverage has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

https://www.medicare.gov/what-medicare-covers

https://www.humana.com/medicare/medicare-resources/irmaa

https://www.healthline.com/health/medicare/what-is-irmaa

https://www.usa.gov/social-security

https://www.healthline.com/health/medicare/what-is-irmaa#how-to-appeal

https://www.healthmarkets.com/resources/medicare/what-is-irmaa/

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Table of Contents

FAQs

  • Best overall Medicare supplement for new enrollees: Plan G.
  • Best overall Medicare supplement before 2020: Plan F.
  • Best low cost Medicare supplement: Plan K.
  • Best alternative to Plan G Medicare supplement: Plan N.

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Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.

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Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.

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The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.

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Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.

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For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.

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It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.

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Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.

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Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.

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  • Plan F$128–$342
  • Plan F (high deductible)$22–$88
  • Plan G$106–$325
  • Plan G (high deductible)$29–$58

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Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.

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The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.

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The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.

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Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.

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It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.

Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.

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Since January 1, 2006, no Medigap policy came with prescription drug coverage. You have two options to get covered, enrolling in either a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage plan.

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