What are Medicare Part D-IRMAA and Part B-IRMAA?

Pamela Cannaday by Pamela Cannaday | Licensed since 2011

This article was updated on: 04/04/2019

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If you’re covered by the Medicare program or about to be eligible for Medicare benefits, you may have heard about the Income-Related Monthly Adjustment Amount, or IRMAA. These new premium adjustments were created under the Affordable Care Act and first went into effect in 2011. They apply to people with higher incomes who are enrolled in Part B or covered under a Medicare Part D Prescription Drug Plan. Here’s what you need to know about IRMAA Part B and IRMAA Part D.

Do I have to pay the IRMAA Part B or IRMAA Part D adjustment?

IRMAA Part B and IRMAA Part D premium adjustments are calculated by the Social Security Administration (SSA) based on information you submit to the Internal Revenue Service (IRS) with your yearly income tax return. IRMAA is based on income data you reported two years ago; in 2018, for example, the SSA uses your 2016 income.

In 2018, if you earned less than $85,000, or you and your spouse filing jointly earned less than $170,000, you will not have to pay IRMAA adjustments with your monthly premium. According to the SSA, fewer than 5% of Medicare beneficiaries are subject to IRMAA Part B and IRMAA Part D premium adjustments.

Does IRMAA Part B and IRMAA Part D apply if I have a Medicare Advantage plan?

If you get your Original Medicare (Part A and Part B) benefits through a Medicare Advantage plan, you may still have to pay Income-Related Monthly Adjustment Amount (IRMAA) Part B if you have qualifying income. This also applies if you get your Medicare Part D prescription drug coverage through a Medicare Advantage plan. IRMAA adjustments are not calculated by your Medicare Advantage or Medicare Part D Prescription Drug Plan; they are assessed by the SSA and paid separately from any premiums you pay to your plan.

It’s important to note that IRMAA Part B and IRMAA Part D are not the same as a late- enrollment penalty. If you are subject to a late enrollment penalty, you will pay this amount for as long as you have coverage under the Medicare program. IRMAA adjustments, on the other hand, can be assessed at any time based on your income data, and they may be removed later if your income falls below qualifying guidelines. If you pay a late-enrollment penalty, you must continue to pay it even if you also pay IRMAA adjustments.

How much is IRMAA Part B and IRMAA Part D?

The chart below shows your monthly Income-Related Monthly Adjustment Amount (IRMAA) adjustments for 2018 based on your modified adjusted gross income (MAGI). MAGI is your total adjusted gross income plus any tax-exempt interest income you receive; this figure is used by the SSA as the basis for IRMAA Part B and Part D adjustments.

Single Married filing jointly Married filing separately Monthly IRMAA Part B Monthly IRMAA Part D
$85,000 or less $170,000 or less $85,000 or less $0 $0
$85,000 to $107,000 $170,001 to $214,000 Not Applicable $53.50 $13.00
$107,001 to $133,500 $214,001 to $267,000 Not Applicable $133.90 $33.60
$133,500 $160,000 $267,001 to $320,000  Not Applicable $214.30 $54.20
Above $160,000 Above $320,000 Above $85,000 $294.60 $74.80

If you are notified that you qualify for IRMAA based on your income, and you disagree with the SSA’s determination, you can always file an appeal using the form Medicare Income-Related Monthly Adjustment Amount Life-Changing Event. You can also use this form if you experience a life-changing event and your income drops at any time.

How will I know if I owe IRMAA amounts and how do I pay them?

If at any point the SSA determines that your income qualifies you for an IRMAA Part D or Part B adjustment, you’ll receive a notice in the mail called the “Initial IRMAA Determination.” This notice has important information about your appeal rights if you disagree with SSA’s decision.

IRMAA isn’t part of your normal Part B or Medicare Part D prescription drug coverage premiums. For most people, IRMAA amounts will be automatically deducted from your Social Security or Railroad Retirement Board (RRB) payments each month. However, if you don’t get Social Security payments or RRB payments, you’ll get a monthly bill. Even if your employer or other third party pays your Medicare premiums for you, you will still get a bill for any IRMAA amounts.

It’s extremely important to pay your IRMAA bill on time each month in order to keep your Medicare coverage. If you don’t pay it, you could lose your Medicare coverage permanently. You may want to sign up for Medicare Easy Pay to make your IRMAA payments automatically.

I’m available to answer any questions you have about IRMAA and Medicare coverage. You can schedule a phone call or request information via email by clicking the appropriate link. To view a list of plans you may qualify for, click the “Compare plans” button below.

You must continue to pay your Medicare Part B premium.

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