How to Avoid Medicare Premium Surcharges | Coldstream Wealth Management (2024)

Halloween overlaps with Medicare open enrollment, which in 2023 is happening between October 15th and December 7th. In the spirit of this festive season filled with ghosts, goblins, and ghouls, we want to warn you of another unwelcomed visitor that may spook you: IRMAA surcharges on your Medicare premiums (queue eerie music)! Read on to learn how to avoid Medicare Premium Surcharges.

What is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount, a new provision enacted by Congress in 2003 and expanded in 2011. IRMAA is a surcharge on your Medicare premiums for parts B (medical insurance) and D (prescription drug plan). It is based on modified adjusted gross incomes (MAGI) at or higher than $97,000 for individuals or $194,000 for married filing jointly couples. Up to five tiers of additional surcharges range from $78.10 to $472.00 monthly per person.

The surcharge is based on your MAGI from two years ago. Thus, your premium rates and IRMAA surcharges for 2024 will be based on your MAGI from 2022.

IRMAA applies to all types of Medicare plans, including Medicare Advantage. If you are subject to paying IRMAA surcharges, you will receive a mailed notification from the Social Security Administration. We recommend holding onto this letter in case you wish to appeal. It will automatically be adjusted if you withhold your Medicare premiums from monthly Social Security payments. You will see the surcharge notated on your monthly bill if you do not withhold your Medicare premiums from Social Security.

Unfortunately, IRMAA is unique because there are no phase-outs for reaching specific thresholds. If you are justone dollarover a threshold, you will pay a significantly higher amount for your Medicare premium. This means your one dollar over the threshold could cost you tens or hundreds of extra premium dollars annually.

PART B ADJUSTMENTS

How to Avoid Medicare Premium Surcharges | Coldstream Wealth Management (1)

Source: Kindness Financial Planning

PART D ADJUSTMENTS

How to Avoid Medicare Premium Surcharges | Coldstream Wealth Management (2)

Source: Kindness Financial Planning

Appealing IRMAA

There are limited qualifying events to appeal IRMAA premium increases. The list includes life-changing events such as:

  • Marriage
  • Divorce or annulment
  • Death of your spouse
  • Work stoppage
  • Work reduction
  • Involuntary loss of income-producing property
  • Loss of pension income
  • Employer settlement payment due to its closure or bankruptcy

You can also appeal if:

  • The IRS data contained an error on your tax return.
  • The IRS sent old data, and you’d like them to use newer information on your tax return.
  • A beneficiary filed an amended tax return for the year the Social Security Administration used to make the IRMAA decision.

You might also try to appeal for other reasons, such as having an abnormally high MAGI from something like a sale that generates a large amount of capital gains. Since this reason is not on the list, you might have a much harder time convincing Social Security to allow this type of exemption.

If you retired within the two years leading up to beginning Medicare at age 65, ask if you qualify for an exemption due to work stoppage to avoid paying rates based on your earned income pre-retirement.

To appeal your IRMAA determination, fill out the Medicare Income-Related Monthly Adjustment Amount – Life-Changing Eventform or schedule an interview withyour local Social Security office(1-800-772-1213). This should be done within 60 days of receiving your IRMAA notice.

Utilizing Financial Planning to Avoid IRMAA

With careful attention, it might be possible to implement planning strategies to lower or eliminate the IRMAA surcharge.

Some people experience a taxable incomeincreasein retirement. Withdrawals and income from pensions, Social Security, and regular or Required Minimum Distributions (RMDs) from IRAs can sometimes generate a similar or higher amount of taxable income. This can be especially pertinent if most of your retirement savings are held within pensions or pre-tax retirement accounts.

Some financial planning strategies you might consider:

  • Make charitable contributions to lower your MAGI. For larger donations, a Donor-Advised Fund may make sense for your plan.
  • Utilize Roth IRA funds instead of an IRA for some cash withdrawals.
  • Spread out withdrawals for cash needs across a few years. For example, if you need $80k for a new car, you could take half of the amount from an IRA in December and the other half in January once the new year begins.
  • If you have earned income, continue to make tax-deductible retirement contributions.
  • In lower tax years, convert funds from a Traditional IRA to a Roth IRA via a Roth conversion. There may be a few years between retirement and when Social Security and RMDs begin, resulting in a few years with a lower tax bracket. Consider utilizing the lower tax bracket to complete a Roth conversion. This can help lower the tax impact of the RMDs that begin between the ages of 73 and 75.

In a perfect world, we would all like to avoid IRMAA surcharges, but it’s important not to lose sight of the bigger financial picture. IRMAA thresholds are just one of many factors when it comes to building out an optimized investment and tax planning strategy. Ask your Coldstream advisory team how you may be affected by IRMAA surcharges and if you can implement any of these strategies into your plan.

Sources:
How to Avoid an IRMAA Medicare Premium Surcharge
Medicare IRMAA Brackets
Request to Lower an Income-Related Monthly Adjustment Amount (IRMAA)
www.Medicare.gov
Part B Costs for Those with Higher Incomes
What is the Medicare IRMAA?
Some Medicare Beneficiaries are Surprised with Premium Surcharges
How to Avoid the IRMAA Surcharge and Pay Less for Medicare
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How to Avoid Medicare Premium Surcharges | Coldstream Wealth Management (2024)

FAQs

How do I fight a high income Medicare surcharge? ›

You will use Form SSA-44 (Medicare Income Related Monthly Adjustment Amount – Life Changing Event). Complete the required information on the form and submit to a local Social Security office. Go to our website at www.medicaremindset.com/irmaa for more detailed instructions, as well as to download the appeal form.

Is there a way to avoid Irmaa? ›

Roth conversions – Paying the IRMAA surcharge for a shorter amount of time and avoiding it later in life might work for you. Doing this by age 69 is suggested. Over-saving in pre-tax accounts – Placing all your savings in pre-tax retirement accounts can be a problem, as discussed in the first bullet above.

How do I get out of paying Irmaa? ›

Appealing an IRMAA decision
  1. Complete a request to SSA for reconsideration. ...
  2. If your reconsideration is successful, your premium amounts will be corrected. ...
  3. If your OMHA level appeal is successful, your premium amount will be corrected. ...
  4. If your Council appeal is successful, your Part B premium amount will be corrected.

Are there surcharges for Medicare for high income earners? ›

If you have a higher income, you'll pay an additional premium amount for Medicare Part B and Medicare prescription drug coverage. We call the additional amount the “income-related monthly adjustment amount.” Here's how it works: Part B helps pay for your doctors' services and outpatient care.

What is the two year rule for Irmaa? ›

The Social Security Administration (SSA) sets four income brackets that determine your (or you and your spouse's) IRMAA. SSA determines if you owe an IRMAA based on the income you reported on your IRS tax return two years prior, meaning two years before the year that you start paying IRMAA.

How do I avoid Medicare Surtax? ›

You can potentially dodge the Medicare 3.8% surtax by keeping your modified adjusted gross income (MAGI) below the threshold.

How do I avoid the Medicare surcharge? ›

Using life-changing events to get a reconsideration of the surcharge
  1. Marriage, divorce or death of a spouse.
  2. Work reduction or stoppage.
  3. Loss of income-producing property.
  4. Loss of pension income.
  5. Employer settlement payment.

What percentage of people have to pay Irmaa? ›

Currently, only 7% of Americans are required to pay an IRMAA. IRMAA calculations are based on your income from two years ago. Whether you must pay an IRMAA in 2023 depends on your 2021 tax returns.

Do pensions count toward Irmaa? ›

Some examples of income used from IRMAA are: Taxable Social Security benefits, Wages, Interest, Capital Gains, Pension and Rental Income, Dividends and any distribution from any tax-deferred investment like a Traditional 401(k), IRA or 403(b).

Does Medicare refund Irmaa? ›

Can you get a refund on Irmaa Medicare? Yes, if you've paid more than the standard Medicare Part B premium, an IRMAA refund can be applied for.

Do I have to pay Irmaa if I have a Medicare Advantage plan? ›

You'll also have to pay this extra amount if you're in a Medicare Advantage Plan that includes drug coverage. If Social Security notifies you about paying a higher amount for your Part D coverage, you're required by law to pay the Part D-Income Related Monthly Adjustment Amount (Part D IRMAA).

Does Social Security automatically adjust Irmaa? ›

The Social Security Administration updates your IRMAA determination each year based on your federal tax return, which is provided by the IRS. If you filed an amended tax return that would affect your IRMAA amount, contact the SSA so they can update their records.

How do I fight Medicare high income surcharge? ›

Fill out the Medicare Income-Related Monthly Adjustment Amount-Life-changing Event (SSA-44) (PDF) form. Fax or mail your completed form and evidence to a Social Security office.

How to avoid irmaa Medicare? ›

Contributing to a tax-deductible retirement account such as a 401k, 403b, IRA, SEP-IRA, etc. Depositing funds into one of these retirement accounts reduces MAGI and could help prevent IRMAA.

How do I get Irmaa reduced? ›

If you've experienced a life-changing event, you can ask the Social Security Administration to reduce or eliminate your IRMAA amount by completing and submitting Form SSA-44.

How do I request an Irmaa reduction? ›

If you filed an amended tax return that demonstrates reduced income, you may request an IRMAA adjustment by calling 1-800-772-1213.

Does Irmaa ever go down? ›

If you've had a life-changing event that reduced your household income, you can ask to lower the additional amount you'll pay for Medicare Part B and Part D. Life-changing events include marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment.

How do I dispute a charge to Medicare? ›

Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Visit Medicare.gov/forms-help-resources/medicare-forms for appeals forms. Call your State Health Insurance Assistance Program (SHIP) for free, personalized health insurance counseling, including help with appeals.

Does Irmaa adjust automatically? ›

The Social Security Administration updates your IRMAA determination each year based on your federal tax return, which is provided by the IRS. If you filed an amended tax return that would affect your IRMAA amount, contact the SSA so they can update their records.

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