Medicare Penalty SURCHARGES IRMAA for high Income
on Part B Doctor Visits & Part D Rx Premiums
Fortunate to earn a Good Living?
If you earn a lot of money, be thankful. Then open up your wallet as it will cost you a little more for Part B – Outpatient – Doctor Visits and Part D Rx. Medi Gap premiums stay the same. No surcharge for Medicare Advantage, but for the Rx portion. See the chart below and the publications on the right.
Note that MAGI for Social Security is a little different here that from the definition for those under 65 in Obamacare. MAGI is the total of your adjusted gross income [line 8 b 1040] and tax-exempt interest income.
Here’s an Explanation in a Specimen MAPD Evidence of Coverage page 20
Most Medicare beneficiaries pay the standard monthly premium, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries (around 6 percent in 2015) with incomes above $87,000 for single people and $174,000 for married couples are required to pay higher premiums for Medicare Part B and Part D—ranging from 35 percent to 80 percent of program costs, that means that your $144/month Part B premium, costs Medicare more than $429/month! and the average $36 Part D premium costs Medicare $112/month, click on footnote KFF.org to view charts! depending on your income (Figure 1). KFF.org
Try turning your phone sideways to see the graphs & pdf's?
- Amplicare.com Medicare Part D Rx Late Enrollment LEP Penalty Calculator
Visit Our Web Pages on:
- Pros & Cons – Pricing if I stay on under 65 plan, if I earn a lot of $$$
- When, How and Where is the bill for the high income surcharge?
- I paid tons of money in taxes, why do I have to pay anything now?
- How to read your bill from Medicare?
- SSA 44 Surcharge Waiver Form
Prescription Drug 2022 #RxGuide
PDF # 11109
Coverage Gap - Donut Hole $2,000 Cap
- Premiums for those with High Income Parts D Rx & B Doctor Visits
- Medicare Rules for High Income People Medicare Costs # 11579
- Our #High Income Surcharge Video Explanation
- Our webpage on High Income Surcharge IRMAA
- Kaiser Foundation Introduction - Overview
- Medicare Rx Benefit Manual Rev 1.2016 83 pages
- Network Pharmacies, Formularies & Common Coverage Rules # 11136
- Insulin Maximum Co Pay $35
- Graphic on Part D Premium Increases & Why?
- Maximus Appeals LEP Late Enrollment Penalty
- VIDEO How Part D Late Enrollment Penalty is calculated
- Shop & Compare Tools Part D Rx
- Get Instant Quotes, Information & Enroll online
- MANDATED wording!: ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’ § 422.2267(e)(41).
- We disagree with the above wording, as we can use the same tools on Medicare.gov as they do!
Calculate your Covered CA MAGI Income
take #Line8b 11 Adjusted Gross income then add line 2a, 6a & 8 (Foreign Income)
- 1040 IRS Annual Tax Form
- Schedule 1 Additional Income & Adjustments to Lower your MAGI Income
- Calculate - Estimate your Taxes
- Steve's Video on MAGI Income
- Get instant quotes, subsidy calculation and coverages
- NO ASSET TEST for MAGI based subsidies in Covered CA or MAGI Medi Cal Qualification. VIDEO
- Nor is there a lien against your estate for Covered CA or MAGI Medi Cal
- 2022 Official Medicare Guide to choosing a Medi Gap Policy # 02110
- Anthem Blue Cross Information & Enrollment
- United Health Care
- Blue Shield – Medi-Gap Information & Enrollment
- Your Rights to Enroll without Health Questions
Medi Gap pays the medical expenses that Original Medicare Part A (Hospital) and Part B (Doctor) doesn't. Check out the chart on this page to see what Medicare Pays, what you pay and what a Medi Gap plan pays.
Original Medicare, Medicare Advantage nor Medi Gap pay for long term care either in a nursing home or at home care. Get more information on Long Term Care here. Even if you think you can't afford any extra premiums, there's a lot of valuable information to help with planning.
The surcharge is based on income from your tax return two years ago—the most recent IRS data the government has when premiums are set in late fall. To determine 2017 premiums, for instance, income reported on your 2015 return filed in early 2016 was used. If your income exceeded the thresholds in 2016, you’ll probably owe the surcharges in 2018, and so on.
What if my income has gone down?
That’s the reason for the word probably in the previous answer. If you got hit with the surcharge this year, but your income has fallen since 2015, you may qualify for a waiver. If you experienced a qualifying “life-changing event,” you can easily get the surcharge waived—but you have to ask. It’s my understanding that the IRS will use a tax return ACTUALLY FILED and not just that you project or ask them nicely that your income has gone down! § 418.1201 (b) Those events include retirement, divorce or death of a spouse. 2022 Kiplincer * kiplinger.com 2017
To determine if you’ll pay higher premiums, Social Security uses the most recent federal tax return the IRS gives them.
(a) In general, we will use your modified adjusted gross income provided by IRS for the tax year 2 years prior to the effective year of the income-related monthly adjustment amount determination. Modified adjusted gross income is based on information you provide to IRS when you file your Federal income tax return. 418.1135
If your income has gone down, however, due to certain specific circumstances, or if you filed an amended tax return, you can ask for a new decision without having to file an appeal. https://www.ssa.gov/pubs/EN-05-10125.pdf
Determinations Using a More Recent Tax Year’s Modified Adjusted Gross Income (§§ 418.1201 – 418.1270)
- § 418.1201 When will we determine your income-related monthly adjustment amount based on the modified adjusted gross income information that you provide for a more recent tax year?
- § 418.1205 What is a major life-changing event?
- § 418.1210 What is not a major life-changing event?
- § 418.1215 What is a significant reduction in your income?
- § 418.1220 What is not a significant reduction in your income?
- § 418.1225 Which more recent tax year will we use?
- § 418.1230 What is the effective date of an income-related monthly adjustment amount initial determination that is based on a more recent tax year?
- § 418.1235 When will we stop using your more recent tax year’s modified adjusted gross income to determine your income-related monthly adjustment amount?
- § 418.1240 Should you notify us if the information you gave us about your modified adjusted gross income for the more recent tax year changes?
- § 418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes?
- § 418.1250 What evidence will you need to support your request that we use a more recent tax year?
- § 418.1255 What kind of major life-changing event evidence will you need to support your request for us to use a more recent tax year?
- § 418.1260 What major life-changing event evidence will we not accept?
- § 418.1265 What kind of significant modified adjusted gross income reduction evidence will you need to support your request?
- § 418.1270 What modified adjusted gross income evidence will we not accept?
Request for Reconsideration ssa-561
- What are the payment options to pay the Part B Premium?
- Easy Pay Premium Statement 11071
- Learn more about how to pay bill online
- Why did the Part B premium go up to $170? Los Angeles Times
- Live Chat with Medicare - Call 1 800 Medicare
Be sure to follow all the links & footnotes above