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March 3, 2021
If you have enough wealth, your Medicare costs — specifically your premiums — might be more than you had bargained for. Not everyone knows this, but there are Medicare surcharges (officially called Income Related Monthly Adjustment Amount, or IRMAA) that correspond to income brackets. These additional costs can really add up. It is the highest-earning 5% of Medicare recipients who pay more for their health coverage.
There are many different costs associated with Medicare. You may pay monthly premiums, IRMAA (see below), coinsurance, as well as co-pays and deductibles.
Your total out-of-pocket costs for Medicare will vary tremendously depending on the types of coverage you select, your income, where you live, your health status, and healthcare usage.
For a personalized estimate of your Medicare costs, use the NewRetirement Planner. It will help you estimate your total lifetime medical spending — including calculating your premiums based on your income.
IRMAA stands for Income Related Monthly Adjustment Amount. Medicare.gov explains that, if your modified adjusted gross income as reported on your IRS tax return from two years ago is above a certain amount, you’ll pay the standard premium amount and IRMAA. IRMAA is an extra cost added to your premiums — specifically parts B and D. Keep reading below to learn about Medicare premiums and just how significantly they rise for those with higher income.
The amounts below come from Medicare.gov. The premium amounts for Medicare Part A and C are mostly standardized — varying by the type of coverage. However, as you will see, the premiums you pay for Medicare Parts B and D will depend on your income level with the highest earners paying up to $5,201 in surcharges.
The monthly premiums for Medicare Part A range from $0–$471. Most people don’t pay a monthly premium for Part A. If you buy Part A, you’ll pay $471 each month in 2021 if you paid Medicare taxes for less than 30 quarters and $259 each month if you paid Medicare taxes for 30–39 quarters.
If you have a higher income, your costs for Medicare Part B premiums can be very high. People in the highest brackets will pay $4,276 more each year than those in the lowest brackets. Review the premium amounts for B for the different income tiers below:
Lowest Bracket: People in the lowest income bracket will pay $148.50/month. The lowest bracket is for those:
Second Tier: $207.90/month for those:
Third Tier: $297/month for those:
Fourth Tier: $386.10/month for those:
Fifth Tier: $475.20/month for those:
Sixth Tier: $504.90/month for those
The Part C — more commonly known as Medicare Advantage — monthly premium varies by plan.
Medicare Part D — prescription drug coverage — premiums also vary depending on what plan you choose. However, there is a standardized surcharge over and above your premium for higher income earners. This surcharge is usually added to your Part B premium and paid to Medicare. The highest earners will pay $925.00 more than the lowest earners as a premium surcharge.
Lowest Bracket: People in the lowest income bracket will pay their plan’s premium with no Medicare surcharge. The lowest bracket is for those:
Second Tier: Those with the following income levels will pay their plan premium, plus an additional $12.30/month:
Third Tier:Those with the following income levels will pay their plan premium, plus an additional $31.80/month:
Fourth Tier: Those with the following income levels will pay their plan premium, plus an additional $51.20/month:
Fifth Tier: Those with the following income levels will pay their plan premium, plus an additional $70.70/month:
Sixth Tier: Those with the following income levels will pay their plan premium, plus an additional $77.10/month:
According to Kaiser, the surcharges were a provision in the Medicare Modernization Act of 2003, a law passed to change how Medicare pays physicians. The law went into effect in 2007 and was updated in 2015.
With some planning, there are steps you can take to avoid or reduce IRMAA. Here are 5 ideas:
You can use the NewRetirement Planner to see your projected annual income and assess when you might be assessed for IRMAA. Free members can review the Cash Flow Forecast. PlannerPlus subscribers can use the Income & Expenses Inspector as well as the Tax Inspector to see your Gross Taxable Income by Source. (The IRMAA surcharges are based on your modified adjusted gross income.)
If you can lower your taxable income below a bracket, you can save hundreds if not a thousand or more on the surcharges. However, minimizing your retirement income can be tricky, especially if you are already taking your Required Minimum Distributions (RMDs) from your tax deferred accounts.
Planning ahead is key. You may be able to shelter income in certain years, manage capital gains, utilize Medicare Savings Accounts, take charitable distributions and consider other strategies. Working with a tax accountant or a Certified Retirement Planner may be helpful.
You can convert money from your taxable retirement savings accounts into a Roth account to avoid having to take RMDs. This can be a great way to reduce taxable income and enable you to avoid IRMAA.
Use the Roth Conversion Explorer in the NewRetirement Planner to see your potential opportunity for reducing your tax and IRMAA liability.
Your IRMAA is based on your income from two years ago. If your circumstances have changed since that time, you can file an appeal with Medicare to let them know about a reduction in income.
Events that might make Medicare reassess your IRMAA include: marriage, divorce, spouse’s death, loss of a job, loss of income generating property, loss of your pension and more.
Healthcare is a major consideration when planning a secure retirement, but there are hundreds if not thousands of different elements that impact your current and future wealth and security.
Make sure that you have a comprehensive plan and that you keep it updated.
Use the NewRetirement Planning Platform to feel in control of your money today and secure about your future. The tools will help you do better with your time, taxes, income, investments, and more.
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