Part B Doctor Visits & D Rx

surcharges for those with high Income

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 RxMedi 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 to view charts! depending on your  income (Figure 1).


Try turning sideways to better view PDF's & Screen Shots

Part D Rx & B Doctor Visits

Surcharge Chart  Publication #11579 

18 comments on “Premiums for those with High Income Parts D Rx & B Doctor Visits

  1. Where does one get the bill for the higher amount?

    From Medicare?

    Medi Gap?

    Medicare Advantage?

    Prescription Company?

    • Part D Rx

      If you have a higher income, you might pay more for your Medicare drug coverage. If your income is above a certain limit ($87,000 if you file individually or $174,000 if you’re married and file jointly), you’ll pay an extra amount in addition to your plan premium (sometimes called “Part D-IRMAA”). You’ll also have to pay this extra amount if you’re in a Medicare Advantage Plan that includes drug coverage. This doesn’t affect everyone, so most people won’t have to pay an extra amount. If you have Part B and you have a higher income, you may also have to pay an extra amount for your Part B premium, even if you don’t have drug coverage. The chart below lists the extra amount costs by income.

      Social Security will contact you if you have to pay Part D IRMAA, based on your income. The amount you pay can change each year. If you have to pay a higher amount for your Part D premium and you disagree (for example, if your income goes down), use this form to contact Social Security [PDF, 125 KB]. If you have questions about your Medicare drug coverage, contact your plan.


      The extra amount you have to pay isn’t part of your plan premium. You don’t pay the extra amount to your plan. Most people have the extra amount taken from their Social Security check. If the amount isn’t taken from your check, you’ll get a bill from Medicare or the Railroad Retirement Board. You must pay this amount to keep your Part D coverage. You’ll also have to pay this extra amount if you’re in a Medicare Advantage Plan that includes drug coverage.

  2. Question

    Why do I have to pay so much for Medicare Part B Doctor Visits?
    I worked hard for over 40 years and paid taxes for it!

    Our Reply

    The Monthly premiums for Part B Dr. Visits and Part D Rx Prescriptions for most people on Medicare only pays 1/4 of what Medicare pays out! That just doesn’t hold up considering Medical Loss Ratio, where Insurance Companies & Government need to take in a dollar to pay out 80c.

    Kaiser Foundation on high income surcharges

    See also our webpage section on how Medicare is funded.

    why so much?

    Again, See our webpage on how Medicare is Funded

  3. Please look at this bill.

    Do I have hospitalization with Medicare and

    is Part D for prescriptions which I also have with United Healthcare?

    • Plain English from

      What year’s income is used?

      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. Those events include retirement, divorce or death of a spouse.


      Our research on “Official” Sites

      It appears to be as soon as you file a tax return with the lower figure.

      How does Social Security determine if I must pay higher premiums?

      To determine if you’ll pay higher premiums, Social Security uses the most recent federal tax return the IRS provides to us.

      Actual CFR Code of Federal Regulations

      (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.

      Request for Reconsideration
      See also link for Medicare & You in upper side panels

  4. I just retired and was earning enough to get the highest surcharge – IRMAA income-related monthly adjustment amount.

    Why does Medicare use income from my tax return filed in 2016 – 2 years prior.

    How to I get the surcharge to be lower now that I’m retired?

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