2013 Update for Part D IRMAA

 

Part D IRMAA

In addition to 2013 Medicare benefits changes that have already taken effect, the income guidelines for Part D Income-Related Monthly Adjustment Amount (also known as “Part D IRMAA”) have also been released and are in effect as well.  This is of particular interest to you if you are a Medicare beneficiary with high income.  Specifically, if you have a high income you will be responsible for paying a Part D IRMAA in addition to your Prescription Drug Plan premium.  

What is Part D IRMAA?

Your monthly premium for Medicare Prescription Drug Plan (also known as “PDP” or “Part D”) could be higher based on your income. This includes the Part D coverage you get from a “stand alone” Medicare Prescription Drug Plan, a Medicare Advantage plan with a “built-in” Prescription Drug Plan (also known as “MAPD”), or a Medicare Cost Plan that includes Medicare Prescription Drug Plan, even if this Part D coverage is through your employer. This extra amount is called the Income-Related Monthly Adjustment Amount, or Part D IRMAA.  You will have to pay this extra amount, or the Part D IRMAA, in addition to your monthly Part D premium.  If your Prescription Drug Plan is a part of a Medicare Advantage plan the portion of premium that is for your Prescription Drug Plan is separated from the part of the premium that is for your medical coverage.  This information can be found in your Summary of Benefits for your specific plan.

Who will have to pay the Part D IRMAA?  

This change affects fewer than 5% of all Medicare beneficiaries.  This means that most people will continue to pay only the Part D premium their plan charges in 2013.  The Social Security Administration will use your reported IRS income to determine if you have to pay a Part D IRMAA and, if so, how much the Part D IRMAA will be each month.  Social Security will send you a letter if you have to pay an extra amount in addition to your monthly Part D plan premium. The specific amounts the Medicare beneficiary will have to pay has been released and is based on your 2011 income tax filing. 

The amount of your Part D IRMAA is based on your 2011 income tax return and the filing status.  The following income guidelines and filing status of individual or married filing separate income tax returns outlines your Part D IRMAA in 2013: 

Beneficiaries who file individual tax returns with income that is:

Beneficiaries who file joint tax returns with income that is:

Medicare Part D Income Related Monthly Adjustment Amount

2013

2012

2011

Less than or equal to $85,000 Less than or equal to $170,000 $0.00 $0.00 $0.00
Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $11.60 $11.60 $12.00
Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 $29.90 $29.90 $31.10
Greater than $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000 $48.30 $48.10 $50.10
Greater than $214,000 Greater than $428,000 $66.60 $66.40 $69.10

Beneficiaries who are married but file separate tax returns with income that is:

Medicare Part D Income Related Monthly Adjustment Amount

2013

2012

2011

Less than or equal to $85,000 $0.00 $0.00 $0.00
Greater than $85,000 and less than or equal to $129,000 $48.30 $48.10 $50.00
Greater than $129,000 $66.60 $66.40 $69.10

Please note:

  • The additional monthly Part D income-related adjustment amount is not collected by the Medicare Part D plans, but instead paid directly to the Federal government.
  • The amount of your IRMAA will be directly deducted from your Social Security, Railroad Retirement Board, or Office of Personnel Management benefits.
  • If there are not sufficient funds in your government benefits, then Medicare will bill you directly.
  • Medicare Part D beneficiaries affected by the 2013 IRMAA will receive a letter from the Social Security Administration notifying them of their Medicare Part D plan premium increase.

If I Have a Part D IRMAA, How Do I Pay It?

If you are responsible for paying a Part D IRMAA then the amount of your Part D IRMAA will be deducted from your monthly Social Security, Railroad Retirement, or Office of Personnel Management check, no matter how you usually pay your Prescription Drug Plan premium.  If you do not receive any of these benefits or the extra amount is more than the amount of your check, you will receive a bill from Medicare or the Railroad Retirement Board (if you are a Railroad retiree) each month. These bills were sent out in December, 2012.  If you did not receive a bill in December, 2012, and your 2011 income is within the amounts set forth above, you may receive your bill after January.  If you receive your bill after January you will have to pay the extra mount for the months that you were not billed for the Part D IRMAA, or in other words, you will pay for more than one month at a time. 

Do Not Pay Your Part D IRMAA to Your Medicare Insurance or Prescription Drug Plan Provider.

It is important to remember that if you get a bill for Part D IRMAA you do not pay this amount to your Part D plan carrier or insurance company.  The Part D IRMAA is to be paid to Medicare or the Railroad Retirement Board.  The letter you receive from Social Security will advise you that your Medicare Prescription Drug Plan premium will change based upon the amount of your Part D IRMAA.  You must pay the Part D IRMAA in order to keep your Medicare Part D coverage. 

What If I Disagree With the Part D IRMAA Calculations?

If you disagree with the Social Security Administration’s decision regarding your Part D IRMAA the letter you receive from Social Security tells you what you can do.  For more information you will need to contact the Social Security Administration at 1-800-772-1213.

Contact Medicare Pathways to Discuss Prescription Drug Plans Available In Your Area!

It is important to keep your Part D IRMAA amount in mind when receiving a quote for a Medicare Advantage plan with a “built in” Prescription Drug Plan or a “stand alone” Prescription Drug Plan because the amount you will be responsible for paying will not be the same as the amount quoted to you.  (A Medicare Supplement plan can never be written with a “built in” Prescription Drug Plan.)  Medicare Pathways Benefit Specialists are not aware of your income amount or your tax filing status in 2011 unless you tell them; therefore, the amount quoted to you will not include the Part D IRMAA.  However, if you suspect you may be responsible for a Part D IRMAA, the Benefit Specialist can advise you of the amount of Part D IRMAA based on the publications released by the Social Security Administration only.  This amount will not be a guaranteed amount but is based solely on publications released by the Social Security Administration.  You can speak with a Medicare Pathways Benefit Specialist by calling 1-866-466-9118, or by simply clicking Request A Quote Today, and a Benefit Specialist will contact you!  

In addition to Prescription Drug Plans, Medicare Pathways also specializes in Medicare Advantage and Medicare Supplement plans and can assist you in finding the most appropriate and most affordable Medicare insurance plan to assist with the out-of-pocket healthcare costs original Medicare leaves you responsible for paying.

 

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