What to Know - Medicare Premium "IRMAA" (2024)

It is that time of year again when the Social Security Administration reviews your Medicare premium costs and alerts you of any changes.

Certain income levels allow an adjustment to your Medicare premiums, called an “Income-Related Monthly Adjustment Amount” (IRMAA). According to the U.S. Department of Health and Human Services (HHS), 4% to 5% of all Part B beneficiaries are subject to an adjustment.

If there is an adjustment, you will be notified in November ofyour premium costs for the next year.

If you disagree with a premium adjustment, see below - you have the right to appeal the decision, but you must have experienced (1) a reduced income plus (2) a qualifying "life-changing event". If so, you typically have 60 days to submit an appeal, so let's connect today to review your options.

Call now, or schedule a Quick Connection time with us today at www.openwindowFS.com/connection.

Surprised to receive an IRMAA letter?

If you're surprised to receive this letter, you're not alone. Premium adjustments arrive unsolicited by mail each November.

The Social Security Administration uses the data you've submitted to the Internal Revenue Service on your tax return. They run your information through a computer and then apply whatever information comes out to a government form letter notifying you of a premium adjustment. The Initial IRMAA Determination Letter can be vague while referring to higher costs. No one likes uncertainty in that regard!

Premium adjustments are two years behind.

The income used to determine your Medicare premium IRMAA is your adjusted gross income plus tax-exempt interest (such as municipal bond interest) from two years ago.

Your 2024 income determines your IRMAA in 2026.

Your 2023 income determines your IRMAA in 2025.

Your 2022 income determines your IRMAA in 2024.

Your 2021 income determines your IRMAA in 2023.

Your 2020 income determines your IRMAA in 2022.

IRMAA Brackets

Current IRMAA brackets are publishedby the Centers for Medicare & Medicaid Services.

Just as your income can be taxed at different levels, there is a tiered system of income brackets used for determining a Medicare premium adjustment.

IRMAA premium adjustments are divided into five additional income brackets. Each bracket can adjust your Part B (hospital) premium and your Part D (prescription drug) premium.

In addition to Medicare's mandatory Part B premium of $2,096.40 yearly ($174.70 monthly) and Medicare's "free" Part D premium of $0.00, premiums for higher-income individuals can potentially increase the total cost of Medicare premiums by 47%, 119%, 191%, 262%, or 286%.

2024 Medicare Brackets (for IRMAA Adjustments)

2024 Premiums are based on 2022 Modified Adjusted Gross Income [MAGI = AGI on Line 11 + Tax Exempt Interest on Line 2a]

IRMAA Tier

Single Filer MAGI

Joint Returns MAGI

Monthly Part B Premium

Monthly Part D Premium

Annual IRMAA Premium Increase (+$2,096.40 base premium)

Premium Increase (%)
--

< $103,000

< $206,000

$174.70

$0.00

+ $0

+ 0%
Tier 1

$103,000 - $129,000

$206,000 - $258,000

+ $69.90

+ $12.90

+ $993.60

+ 47%
Tier 2

$129,000 - $161,000

$258,000 - $322,000

+ $174.70

+ $33.30

+ $2,496.00

+ 119%
Tier 3

$161,000 - $193,000

$322,000 - $386,000

+ $279.50

+ $53.80

+ $3,999.60

+ 191%
Tier 4

$193,000 - $500,000

$386,000 - $750,000

+ $384.30

+ $74.20

+ $5,502.00

+ 262%
Tier 5

> $500,000

> $750,000

+ $419.30

+ $81.00

+ $6,003.60

+ 286%

[Table updated November 9, 2023, with Part B and Part D premiums announced by the Centers for Medicare & Medicaid Services]

Planning Around IRMAA

The key to IRMAA planning is awareness of the IRMAA brackets.

Most of all, make sure you don't run over the cliff into a higher bracket. Unlike income tax brackets, where only the dollars in the next bracket are taxed at that higher bracket, the lines between IRMAA brackets represent an "all or nothing" line in the sand.

If you cross into a new bracket by just one dollar ($1), you face a sudden jump in the entire premium you pay for the entire year.

INTENTIONALLY PAYING a higher premium for Medicare?

There are many reasons why intentionally paying a higher IRMAA makes perfect sense.

A Roth conversion represents one good reason to pay IRMAA.

A well-executed Roth conversion raises your income and can push you into a higher IRMAA bracket. In exchange, you stand to receive a number of benefits, especially when conversions are planned over many years, even decades. These include the potential for lower required distributions, higher-quality inheritances, higher Social Security benefits, and lower Medicare premiums (when planned correctly).

Read more of our thoughts on the benefits of Roth conversions here.

Appealingan IRMAA Decision

If you disagree with a premium adjustment, you have the right to appeal the decision.

You might be successful in appealing a premium adjustment decision if you believethat there was an error in the IRS data, or perhaps youfiled an amended tax return and the IRS is using older or incomplete data.

Otherwise, appeals must be related to several qualifying "life-changing events", including:

  • Work reduction
  • Work stoppage
  • Death of spouse
  • Divorce or annulment
  • Loss or reduction of certain kinds of pension income
  • Marriage
  • Loss of certain kinds of income-producing property (usually due to a natural disaster, arson, fraud, or theft)
  • Receipt of an employer settlement payment

Your appeal options are worth reviewing with us here:www.openwindowFS.com/connect.

Many eligible appeals tend to occur in the initial years of retirement (or after a break from employment) when your income reported to the IRS declines compared to the previous. For example, if your income was higher two years ago because you were working and today your income is significantly lower, you can appeal the IRMAA assessment due to "Work reduction" or "Work stoppage".

  1. To appeal the decision, first, you must request a reconsideration of the initial determination. A request for reconsideration can be made by calling the Social Security Administration at 1-800-772-1213 or by writing to your local Social Security office.

  2. Next, file an appeal by filling out form SSA-44. In the example above, you'll show that although your income was higher two years ago, your income is now reduced due to a "life-changing event".

For additional information on appeals, go to HHS.gov: Medicare Part B Premium Appeals.

IRMAA is re-evaluated each year.

Do you feel stuck with an IRMAA premium increase? If you aren't granted an appeal, you will pay the higher Medicare premium(s) for one year. Fortunately, IRMAA is re-evaluated each year.

Concerned about your IRMAA exposure?

If you're concerned about your IRMAA exposure, contact us today. We are well aware of these brackets and when you might intentionally pursue an adjustment or not, plus the tools available to plan for these costs.

If you received an IRMAA letter, feel free to share your letter with us for discussion or if you have any questions.

You can securely share your IRMAA letter with us here:www.openwindowFS.com/share.

What to Know - Medicare Premium "IRMAA" (2024)

FAQs

What to Know - Medicare Premium "IRMAA"? ›

The IRMAA is calculated on a sliding scale with five income brackets topping out at $500,000 and $750,000 for individual and joint filing, respectively. These figures change annually with inflation. IRMAA calculations have a two-year lag time. Whether you pay an IRMAA in 2024 depends on your 2022 tax returns.

What you need to know about Irmaa? ›

The income-related monthly adjustment amount is a fee you may have to pay on Part B and Part D premiums. The Medicare IRMAA is based on the income on your tax return two years prior. IRMAA charges apply to eligible Medicare beneficiaries, whether you have Original Medicare or Medicare Advantage.

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 to avoid irmaa for Medicare? ›

How to Avoid IRMAA
  1. Adopting a tax-smart retirement withdrawal strategy.
  2. Allocating to tax-efficient investments.
  3. Utilizing a Medicare Savings Account (MSA)
  4. Tax-Gain Harvesting.
  5. Processing Roth conversions.
  6. Requesting a recalculation of IRMAA due to a “life-changing event” using Form SSA-44.
May 1, 2024

What will the Irmaa brackets be for 2024 Medicare? ›

Official IRMAA 2024 Brackets
SingleCouple MAGIPart B
< $103,000< $206,000$174.70
$103,000 to $129,000$206,000 to $258,000$244.60
$129,000 to $161,000$258,000 to $322,000$349.40
$161,000 to $193,000$322,000 to $386,000$454.20
2 more rows
May 16, 2024

What income counts against Irmaa? ›

CMS, which calculates both Medicare Part B monthly premium amounts and IRMAA, uses what is known as Modified Adjusted Gross Income (MAGI). MAGI includes not only wages but also dividends, capital gains, tax-exempt interest income, and more.

How far back does Irmaa look? ›

IRMAA is determined by income from your income tax returns two years prior.

How do I get my 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.

Does Irmaa reset every year? ›

IRMAA is calculated every year. That means if your income is higher or lower year after year, your IRMAA status can change. If the SSA determines you must pay an IRMAA, you'll receive a notice with the new premium amount and the reason for their determination.

Do 401k contributions reduce Irmaa? ›

If you are still working and can make tax-deductible contributions to a Traditional IRA or Traditional 401(k), TSP, 403(b), or 457 plan, you can reduce your taxable income and reduce or avoid IRMAA.

Does everyone pay $170 for Medicare? ›

If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($174.70 in 2024). Social Security will tell you the exact amount you'll pay for Part B in 2024.

Does Irmaa apply to both spouses? ›

Does IRMAA Apply to Both Spouses? IRMAA applies to both spouses when both are on Medicare. Medicare premiums are charged to each individual beneficiary as there is no “family plan.”

At what income level do my Medicare premiums increase? ›

What are the rules for higher-income beneficiaries?
SingleMarried Filing JointlyPart D IRMAA
$97,000 or less$194,000 or less$0 + your plan premium
$183,000 and under $500,000$366,000 and under $750,000$70.00 + your plan premium
$500,000 or above$750,000 and above$76.40 + your plan premium
3 more rows
Sep 21, 2023

What qualifies as a life-changing event for Irmaa? ›

Life-changing events include marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment.

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).

Do both spouses have to pay Irmaa? ›

Does IRMAA Apply to Both Spouses? IRMAA applies to both spouses when both are on Medicare. Medicare premiums are charged to each individual beneficiary as there is no “family plan.”

How to calculate modified adjusted gross income for Medicare premiums? ›

MAGI is calculated as Adjusted Gross Income (line 11 of IRS Form 1040) plus tax-exempt interest income (line 2a of IRS Form 1040). The table below details the base premium amount you'll pay for Medicare in 2024 depending on your MAGI and filing status, inclusive of any additional IRMAA surcharge.

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