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How Are Medicare Premiums Determined?

Your income can affect what you pay for Part B and Part D — here's how that works.

Talk to a Licensed Agent: (302) 407-0876

The Basics of Premium Funding

Most people don't pay a Part A premium if they or a spouse paid Medicare taxes while working. Part B, on the other hand, requires a monthly premium from nearly everyone enrolled, funded partly by general tax revenue and partly by beneficiary premiums.

Part C (Medicare Advantage) premiums are set by the private insurer offering the plan and vary widely, including many $0-premium options. Part D premiums are also set by the plan you choose, whether standalone or bundled into Medicare Advantage.

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Income-Related Adjustments (IRMAA)

If your income is above a certain threshold, you may owe an Income-Related Monthly Adjustment Amount, or IRMAA — a surcharge added to your standard Part B and Part D premiums. IRMAA is based on your modified adjusted gross income from your tax return, generally from two years prior.

If your income has dropped since that tax return due to a major life event — such as retirement, divorce, or the death of a spouse — you can file an appeal with Social Security to have your IRMAA reconsidered based on your current circumstances, rather than the older, higher-income year.

Frequently Asked Questions

It's an Income-Related Monthly Adjustment Amount — an extra charge added to your Part B and Part D premiums if your income is above a certain threshold.