Did you know you might be paying upwards of $15,000 over the next two years in additional payments for your Medicare coverage than you need to be? Did you know the Social Security Administration uses your tax returns from the past two years to determine your current income and therefore whether or not you need to pay extra for your coverage?
Read below to find out if you are overpaying for your Medicare coverage and could save thousands of dollars by filing a simple appeal.
What is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. The Social Security Administration defines IRMAA as a sliding scale of “a set of statutory percentage-based tables used to adjust Medicare Part B and Part D prescription drug coverage premiums.” In simpler terms, if you make over a certain amount of income, you have to pay more for your Part B and/or Part D premiums. IRMAA only affects those enrolled in Medicare Part B and/or D (Source).
The SSA calculates whether or not you pay an IRMAA based on your income from the previous two years’ tax returns. So if you plan to start Medicare the year you turn 65, the IRMAA will be calculated using the tax returns from the two years prior. IRMAA calculates your income using a calculation to get to a MAGI- a “modified adjusted gross income” that is The income that counts is the adjusted gross income you reported plus other forms of tax-exempt income (Source). Examples of income added back in that counts in your MAGI include (but are not limited to) student loan interest, IRA contributions, any passive income loss, deductions for tuition and fees, and taxable social security payments (Source). The MAGI threshold in 2021 for avoiding IRMAA was an income below $88,000 for individuals and $176,000 for married couples filing jointly (Source). There are multiple income brackets, so the higher your MAGI, the higher your IRMAA.
What does IRMAA Cost?
For Medicare Part B in 2022, the premium costs $170.10 per month. This is a 14.5% increase from last year, when it was $21.60 per month. The good news is that even though the premiums increased from 2021 to 2022, the MAGI thresholds hardly moved, so most people stayed in the same bracket (and at least didn’t get bumped up into a higher surcharge) (Source).
Part D IRMAA (Source)
Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
Part D IRMAA (Source)
Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
How Will I Know if I Have to Pay IRMAA?
You will not have to identify yourself as requiring an IRMAA; The SSA will contact you to let you know that you qualify for IRMAA and will therefore be paying more for Medicare Part B and/or Part D. The Initial IRMAA Determination will arrive in the mail and will explain the costs and your right to appeal. For example, if you enroll in Medicare when you turn 65, you may have had other life changes that year that aren’t reflected on your previous two years’ tax returns. Perhaps you retired, or your spouse retired, or your income drastically changed for other reasons. For those and other reasons, such as simply believing your IRMAA was miscalculated, “you have the right to request that SSA lower or eliminate your premium increase. You will have to submit evidence whether you are appealing SSA’s original determination or requesting a new determination” (Source).
See below for life-changing events Social Security considers for IRMAA adjustments:
You married,
You divorced, or your marriage was annulled,
You became a widow or widower,
You or your spouse stopped working or reduced work hours,
You or your spouse lost income-producing property due to a disaster or other event beyond your control,
You or your spouse experienced a scheduled cessation, termination, or reorganization of an employer’s pension plan, or
You or your spouse received a settlement from an employer or former employer because of the employer’s closure, bankruptcy or reorganization.
According to the appeal form, “You will need to submit proof of the event listed above that caused your income to go down (such as a death certificate, a letter from your pension fund administrator, or a letter from your employer about your retirement).”
The bill will be sent to the address on file, and you will pay it directly to Medicare. Another option is to enroll in Medicare Easy Pay online.
How Can I Eliminate my IRMAA?
Proactively, you can avoid getting issued an IRMAA by notifying the SSA of changes to your income that aren’t reflected in your past two years’ tax returns and avoid the appeals process. On the SSA website you can fill out a “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event” form or you can schedule a meeting with your local Social Security office (1-800-772-1213). “Even if you are married, file jointly, and only had one spouse experience the precipitating event, both spouses should submit an individual appeal” (Source).
If you wait until you get your Initial IRMAA Determination letter, it is important to take action as quickly as possible. You have 60 days from the Initial IRMAA Determination letter to file your appeal. To see if you qualify for an appeal, verify that you meet one of the requirements here and then you can appeal by calling the SSA, going into a local office, or filing online.
Up until the decision is overturned, you will have to pay the IRMAA or risk losing your Medicare coverage. However, the great news is that once your appeal is approved, the SSA will “retroactively refund the excess IRMAA amount paid” (Source).
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