IRMAA 2024 For Medicare: What You Need To Know (2024)

The monthly premium a person pays for their Medicare coverage is based on their annual income. For higher-income beneficiaries, a surcharge known as the income-related monthly adjustment amount, or IRMAA, is added on top of the standard premium for Medicare Part B ($164.90 for 2023) and Medicare Part D (prescription drug coverage) premium, which varies by plan.

“The income-based surcharge is determined each year by the Social Security Administration,” says Jeff Collins, a Medicare expert and vice president of government programs at MVP Health Care, a health insurance provider with locations in New York and Vermont.

The Social Security Administration also sets the income thresholds used to determine who’s subject to IRMAA. The IRMAA doesn’t apply to beneficiaries with an income under the established threshold, adds Collins.

How Is the Medicare IRMAA Calculated for 2023?

The annual Medicare IRMAA is determined using a person’s modified adjusted gross income (MAGI) from two years prior. MAGI is calculated based on the following information:

• A person’s adjusted gross income (AGI) on their federal tax return, which is calculated by subtracting allowed adjustments, such as conventional IRA contributions, from gross income
• Excluded foreign income
• Nontaxable Social Security benefits, such as tier 1 railroad retirement benefits
• Tax-exempt interest

Those with a MAGI higher than the income thresholds set by the Social Security Administration are required to pay IRMAA in addition to their Medicare Part B and/or Part D monthly premiums.

“IRMAA only applies to people enrolled in Medicare Part B and/or Medicare Part D,” explains Collins. “In most cases, the government pays the majority of Part B and Part D coverage. However, only people above certain income levels pay an IRMAA surcharge.”

The 2023 income threshold for Medicare IRMAA is $97,000 for beneficiaries filing individual tax returns and $194,000 for beneficiaries filing joint tax returns. Those earning more than these specified amounts are required to pay the Medicare IRMAA.

Above these thresholds, the exact IRMAA varies. “The amount of IRMAA payment depends on the individual’s income level and may change from year to year,” adds Collins.

According to CMS, if a person’s MAGI on their IRS tax return from two years ago is above a certain amount, they’re required to pay an IRMAA in addition to their standard monthly Part B premium.

IRMAA 2023 for Full Medicare Part B Coverage

The 2023 IRMAAs and total monthly premium amounts for Medicare beneficiaries with full Part B coverage who file individual or joint tax returns are shown in the table below.

The 2023 IRMAAs and total monthly premium amounts for Medicare beneficiaries with full Part B coverage who are married and live with their spouse at any time throughout the year but file separate tax returns are shown in the table below.

IRMAA 2023 for Medicare Part B Immunosuppressive Drug Coverage Only

People with Medicare due to a diagnosis of end-stage renal disease currently lose their coverage 36 months after a kidney transplant unless they’re otherwise eligible for Medicare. However, eligible individuals can now qualify for continuous Medicare-covered immunosuppressive drugs via a new benefit called Medicare Part B Immunosuppressive Drug (Part B-ID). As the name suggests, it exclusively covers immunosuppressive drugs for these beneficiaries.

The 2023 IRMAAs and total monthly premium amounts for Medicare beneficiaries with Part B-ID coverage who file individual or joint tax returns are shown in the table below.

The 2023 IRMAAs and total monthly premium amounts for Medicare beneficiaries with Part B-ID coverage who are married and live with their spouse at any time throughout the year but file separate tax returns are shown in the table below.

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According to CMS, if a person’s MAGI on their IRS tax return from two years ago is above a certain amount, they’re required to pay IRMAA in addition to their monthly Part D premium, which varies based on the plan.

The 2023 IRMAAs for Medicare Part D beneficiaries who file individual or joint tax returns are shown in the table below.

The 2023 IRMAAs for Medicare Part D beneficiaries who are married and live with their spouse at any time throughout the year but file separate tax returns are shown in the table below.

“Medicare Advantage plans do not have a separate IRMAA”, says Collins. But IRMAA applies to any person who has Medicare Part B and/or Part D coverage regardless of whether they have a Medicare Advantage plan, he adds.

Individuals enrolled in a Medicare Advantage plan are also responsible for paying monthly Medicare Part B premiums. Therefore, a Medicare Advantage beneficiary pays the monthly premium for their Medicare Advantage plan, the standard monthly Medicare Part B premium and, if their income exceeds the threshold listed above, an IRMAA on their Medicare Part B premium.

However, many Medicare Advantage plans include prescription drug coverage, so beneficiaries can avoid enrolling in a separate Part D plan, for which they would need to pay another monthly premium and potential IRMAA depending on their annual income.

To learn more about Medicare Advantage coverage in your state, select your locale in the dropdown menu below.

In most cases, IRMAA payments are automatically deducted from an individual’s Social Security benefit checks.

If payments aren’t automatically deducted from one’s Social Security benefit checks, they receive a monthly bill from Medicare. According to the CMS, the bill usually arrives around the 10th of every month and must be paid in full by the 25th of each month to avoid loss of Medicare coverage.

Medicare beneficiaries can pay their bills in the following four ways:

• Pay online through their secure Medicare account.
• Sign up for Medicare Easy Pay for automatic deductions from their savings or checking account.
• Set up payment with their bank’s online bill payment service, using their savings or checking account (which may incur a service fee).
• Mail their payment directly to the Medicare office.

“People who think their IRMAA is too high or that the federal government made an error may appeal,” says Collins. “The appeal process is available to anyone affected by IRMAA, with the final determination made by the Social Security Administration.”

Following an appeal request, instructions detailing the appeal process and how to request a new initial determination are sent to the beneficiary with the initial determination letter from the Social Security Administration. The appeal may be filed with Social Security in writing or by phone. Appeal forms are also available from local Social Security offices or online at the Social Security website, explains Collins.

“Social Security may revisit its initial determination if a life-changing event caused an income decrease or if the income information used was incorrect or outdated,” he adds.