Staying Fit

Most people who enroll in Medicare Part B, which covers doctor visits, diagnostic tests and other outpatient services, pay a standard monthly premium, which is $164.90 in 2023. But if your household income is above a certain amount, you may have to pay more than the basic monthly fee. If the government says your monthly tab is going to be higher, there are ways to appeal that decision.
The added charge, known by the acronym IRMAA (income-related monthly adjustment amount) was included in the 2003 Medicare Modernization Act, designed to help financially stabilize the program. According to the Centers for Medicare and Medicaid Services (CMS), about 7 percent of Medicare beneficiaries are subject to these higher premiums.

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“The idea is that people with higher levels of income should be paying more,” says Alex S. Seleznev, a wealth management specialist and certified financial planner.
CMS decides each year how much higher-income Medicare recipients will have to pay; the Social Security Administration (SSA) determines who must make those added payments.
The added charge is based on a beneficiary’s “modified adjusted gross income (MAGI),” which is your total adjusted gross income plus any tax-exempt interest that you report on your federal 1040 tax form. For example, individuals with annual incomes of $97,000 are subject to a higher premium in 2023, while the income threshold for joint filers is $194,000.
Here’s the tricky part: The SSA doesn’t use your most recent tax return to figure out whether you have to pay higher premiums. It looks back two years. That means the income on your 2021 tax return — filed in 2022 — will determine what you’ll have to pay in 2023.
Depending on your annual income, the amount you’ll have to pay above the basic Part B premium could range from about $66 to about $396 a month next year. The high-income charge also applies to Part D prescription drug coverage, and those extra charges could range from about $12 to $78 a month, also based on your 2021 income. Part D plan premiums vary widely, depending on what plan you pick and where you live. These surcharges apply whether you are enrolled in original Medicare (Parts A and B) or a Medicare Advantage plan.
Surcharges for Medicare Part B in 2023 (in addition to monthly premiums)
Individuals (based on 2021 modified adjusted gross income) |
Joint filers (based on 2021 modified adjusted gross income) |
2023 IRMAA |
Less than or equal to $97,000 |
Less than or equal to $194,000 |
$0.00 |
Greater than $97,000 and less than or equal to $123,000 |
Greater than $194,000 and less than or equal to $246,000 |
$65.90 |
Greater than $123,000 and less than or equal to $153,000 |
Greater than $246,000 and less than or equal to $306,000 |
$164.80 |
Greater than $153,000 and less than or equal to $183,000 |
Greater than $306,000 and less than or equal to $366,000 |
$263.70 |
Greater than $183,000 and less than $500,000 |
Greater than $366,000 and less than $750,000 |
$362.60 |
$500,000 and above |
$750,000 and above |
$395.60 |
Source: Medicare
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