IRMMA is the Income-Related Monthly Adjustment Amount that can be applied to a Medicare beneficiary’s Medicare Part D and Medicare Part B premiums. IRMMA affects only those Medicare beneficiaries who have high incomes. Specifically, Medicare beneficiaries who have a modified adjusted gross income of more than $85,000.00 for individuals or $170,000.00 for married couples filing joint income tax returns pay an additional Medicare Part D and/or Medicare Part B Income-Related Monthly Adjusted Amount (IRMMA) based on their income. Therefore, if you have a yearly modified adjusted gross income in that is less than $85,000.00 for an individual or $170,000.00 if you are married and filed your income tax jointly, you will not pay IRMMA payments and, therefore, your Medicare Part D and/or Medicare Part B premiums will not be affected.
With regard to a Medicare beneficiaries Part B premium, the Health Care Reform Law froze the threshold for income related Part B premiums at the 2010 levels. The IRMMA relating to Medicare Part B premium will remain at the 2010 levels through 2019. If the Medicare beneficiary’s income does not fall within the amounts identified above ($85,000.00 for individuals or $170,000.00 for married couples filing joint income tax returns), then their Medicare Part B premium is $99.90. However, if the Medicare beneficiary has a higher income then his or her income-related Part B premium will range from $161.50 to $369.10 per month, depending on their income. By 2019, the HHS Office of the Actuary projects income-related Part B premium amounts will range from $224 to $512 per month.
The IRMMA payments were initiated in January 2011, and are mandated by the Affordable Care Act to help fund the Medicare Part D Trust Fund. The Part D IRMMA can change every year because it is calculated based on the most recent standard based premium. In 2012, the base premium is $31.08 and for 2013 the base premium is $31.17. With just a slight increase in the standard based premium from 2012 to 2013, Medicare beneficiaries with higher incomes will see either no increase in their premium, or only a slight increase in their premium for IRMMA payments. 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.
Please note that the additional monthly income-related adjustment is not collected by the Medicare Part D plan carriers, but instead is paid directly to the Federal Government. The amount of your IRMAA payment 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. In this case, you will receive a bill from your Medicare Part D plan carrier for the amount of your Part D premium and a separate bill from the Center for Medicare Services (also known as “CMS”) for your IRMMA payment. Failure to pay your IRMMA will result in disenrollment from your Medicare Part D Plan by CMS.
If you are disenrolled from a Medicare Part D plan based on failure to pay IRMMA payments you will not be able to enroll in another Medicare Part D plan again until the next valid election period. This could be the Annual Election Period (also known as “AEP”) or a Special Election Period (also known as “SEP”). However, if the Medicare beneficiary goes sixty three days or more without Medicare Part D coverage or other creditable coverage, they will be assessed a Medicare Part D late enrollment penalty. (For more information regarding Part D penalties see the article titled “What is the Medicare Part D Penalty.”) While CMS does not stop re-enrollment into a Medicare Part D Plan during an election period, you will be required to pay any Medicare Part D late penalties, if applicable, as well as any past due IRMMA payments.
Medicare Pathways,Inc. 1-866-466-9118
Visit our Medicare News Blog