Understanding How Income Determines Medicare Premiums

by David Bynon, last updated

Medicare, the federal health insurance program for seniors and certain individuals with disabilities, is crucial in ensuring access to affordable healthcare. However, Medicare coverage costs can vary depending on several factors, including income.

This blog post will explore how income determines Medicare premiums, helping you understand the potential impact on your healthcare costs.

Medicare Part B Premiums

Medicare Part B covers medical services such as doctor visits, outpatient care, and preventive services. Most beneficiaries are required to pay a monthly premium for Part B coverage.

The federal government sets the standard Part B premium each year. However, an Income-Related Monthly Adjustment Amount (IRMAA) may apply for individuals with higher incomes, resulting in higher premium amounts.

IRMAA is an additional surcharge added to the standard Part B premium for beneficiaries with higher incomes. It is calculated based on the modified adjusted gross income (MAGI) reported on your tax return from two years prior.

The Social Security Administration (SSA) determines your IRMAA by reviewing your tax return data provided by the Internal Revenue Service (IRS).

IRMAA Income Brackets

The IRMAA is divided into different income brackets, each with its corresponding premium adjustment. The income brackets and associated IRMAA amounts are updated annually by the Centers for Medicare & Medicaid Services (CMS). The IRMAA thresholds for 2023 are as follows:

If your filing status and MAGI in the tax year 2021 was:

Individual Return
Joint Return
Married Filing Separate
Part B
Part D
$97,000 or less $194,000 or less $97,000 or less $164.90 No Surcharge
$97,000 – $123,000 $194,000 – $246,000 N/A $230.80 + $12.20
$123,000 – $153,000
$246,000 – $306,000
+ $31.50
$153,000 – $183,000
$306,000 – $366,000
+ $50.70
$183,000 – $500,000
$366,000 – $750,000
$97,000 – $403,000
+ $70.00
Over $500,000
Over $750,000
Over $403,000
+ $76.40

The SSA determines your IRMAA based on the tax return information provided by the IRS. If your income has changed since the tax return data used to calculate your premium, you may request a new initial determination from the SSA.

This process, known as a “life-changing event,” allows you to provide updated income information to potentially reduce or eliminate the IRMAA. Fill out the Medicare Income-Related Monthly Adjustment Amount-Life-changing Event (SSA-44) (PDF) form. You can fax or mail your completed form and evidence to a Social Security office.

Other Medicare Parts and Premiums

While Part B premiums are primarily affected by income, it’s important to note that income does not directly impact Part A (hospital insurance) premiums for most beneficiaries.

Part D (prescription drug coverage) premiums can vary based on income, but the income thresholds and calculations differ from those of Part B.


Understanding how income determines Medicare premiums is crucial for planning your healthcare costs. The IRMAA adds an additional amount to the standard Part B premium for beneficiaries with higher incomes.

By knowing the income brackets and keeping your income information up to date, you can effectively anticipate and manage your Medicare premiums, ensuring that you have affordable access to the healthcare services you need.

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