In 2024 the Medicare Board of Trustees is projecting that over 7.5 million retirees will be in IRMAA, and it will cost them an extra $23.4 billion, but, exactly, what is IRMAA?
What is IRMAA?
IRMAA is an acronym that stands for medicare’s Income Related Monthly Adjustment Amount.
The Medicare Handbook defines IRMAA as “an extra charge to your premium” if you are earning too much income.
Ultimately, IRMAA is a tax on your income through Medicare, but you have to be earning a certain amount of income beforehand to qualify for it.
Who is IRMAA for?
According to Social security.gov, which is responsible for placing people in IRMAA and collecting the surcharges, IRMAA is for:
Medicare beneficiaries that “have modified adjusted gross income (MAGI) above the threshold for their tax filing status pay an IRMAA in addition to the monthly premium.”
These Medicare beneficiaries that are eligible for IRMAA must be in either or:
- Medicare Part B.
- Medicare Part D.
- Medicare Advantage Plan with or without prescription drug coverage.
- They also must not be receiving financial assistance in meeting any of the premiums too.
When did IRMAA start?
IRMAA was established in 2003 with Congress passing the Medicare Modernization Act.
It did not take effect until 2007.
How do you qualify for IRMAA?
You qualify for IRMAA by your modified adjusted gross income or MAGI. The greater your MAGI the greater your possibility of not only reaching it, but also possibly finding yourself in a higher surcharge bracket.
There are 5 different IRMAA thresholds that increase by income which in 2024 are:
| Individual MAGI | Couple MAGI | Part B (monthly) | Part D (monthly) |
|---|---|---|---|
| <$103,000 | <$206,000 | $174.70 | Premiums (varies) |
| $103,000 – $129,000 | $206,000 – $258,000 | $244.60 | Premium + $12.90 |
| $129,000 – $161,000 | $258,000 – $322,000 | $394.40 | Premium + $33.30 |
| $161,000 – $193,000 | $322,000 – $386,000 | $454.20 | Premium + $53.80 |
| $193,000 to $500,000 | $386,000 to $750,000 | $559.00 | Premium + $74.20 |
| >$500,000 | >$750,000 | $594.00 | Premium + $81.00 |
Which Tax Return does Social Security use?
The Social Security Administration will always ask, electronically, the Internal Revenue Services (IRS) for the MAGI amounts of all Medicare beneficiaries who are not receiving financial help in either October or November of the current year.
Because the tax year is not complete the IRS will use the previous year’s tax return.
The Steps of the IRMAA determination process:
- Step 1: The Centers for Medicare Services (CMS) around the end of October will create the IRAA Thresholds for 2024.
- Step 2: CMS will then notify the Social Security Administration (SSA) to ask the to determine who will be in IRMAA for 2024.
- Step 3: The SSA will, electronically, send the Social Security Numbers (SSN) of every eligible Medicare beneficiary to the Internal Revenue Service (IRS). They will request the MAGI amounts for those who are over at least the initial IRMAA Threshold.