Medicare Blog

what determines when my medicare premium increases?

by Jared Christiansen Published 2 years ago Updated 1 year ago

Exactly how much your premiums increased though, isn’t based on your current health or Medicare plan or your income. Rather, it’s the soaring prices of overall healthcare. However, about 7% of Medicare beneficiaries pay higher-than-standard premiums based on the income shown in their tax returns from two years ago.

Medicare premiums are based on your modified adjusted gross income, or MAGI. That's your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS.Jun 16, 2022

Full Answer

Why are my Medicare premiums so high?

Social Security is deducting $297 per month for my Medicare Part B coverage ... If so, it seems kind of high. Can you explain why I’m paying so much for Medicare Part B? Your Part B premium of $297/month has nothing to do with the Windfall Elimination ...

Why did my Medicare premium just go up?

Why did my Medicare premiums go up?

  • Charles – Md.: Congress saw fit to increase monthly Medicare premiums in 2018. ...
  • Susan – Vt.: Because Medicare is for the seniors, it should cover the things we need. ...
  • Anonymous — Ariz.: I will turn 65 in September. ...
  • Maggie – Va.: I am a surviving spouse, aged 68, and have been collecting a widow’s benefit for the past two years.

How does income affect monthly Medicare premiums?

  • Marriage
  • Divorce/Annulment
  • Death of Your Spouse
  • Work Stoppage or Reduction
  • Loss of Income-Producing Property
  • Loss of Pension Income
  • Employer Settlement Payment

Why are health insurance premiums rising so fast?

Why Are Healthcare Costs Rising?

  • Service price and intensity
  • Population growth
  • Population aging
  • Disease prevalence or incidence
  • Medical service utilization

What triggers higher Medicare premiums?

If you file your taxes as “married, filing jointly” and your MAGI is greater than $182,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $91,000, you'll pay higher premiums.

Are Medicare premiums recalculated every year?

Remember, Part B Costs Can Change Every Year The Part B premium is calculated every year. You may see a change in the amount of your Social Security checks or in the premium bills you receive from Medicare. Check the amount you're being charged and follow up with Medicare or the IRS if you have questions.

What income is used to determine Medicare premiums?

modified adjusted gross incomeMedicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.

What are Medicare premiums for 2021?

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020.

Why did my Medicare Part B go up?

This is called the cost of living adjustment, or COLA, and is a way to help benefit payments keep up with the cost of living. The cost of health care often rises faster than inflation, however.

How much will Medicare premiums increase in 2022?

$170.10 a monthMedicare premiums are rising sharply next year, cutting into the large Social Security cost-of-living increase. The basic monthly premium will jump 15.5 percent, or $21.60, from $148.50 to $170.10 a month.

Does my income affect my Medicare premiums?

Medicare premiums are based on your modified adjusted gross income, or MAGI. That's your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS.

Do Medicare premiums decrease with income?

If you have higher income, you'll pay an additional premium amount for Medicare Part B and Medicare prescription drug coverage. We call the additional amount the income-related monthly adjustment amount.

Does Social Security count as income for Medicare?

All types of Social Security income, whether taxable or not, received by a tax filer counts toward household income for eligibility purposes for both Medicaid and Marketplace financial assistance.

What is the standard Medicare Part B premium for 2021?

$148.50Medicare Part B Premium and Deductible The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. The annual deductible for all Medicare Part B beneficiaries is $233 in 2022, an increase of $30 from the annual deductible of $203 in 2021.

How do I get my $144 back from Medicare?

Even though you're paying less for the monthly premium, you don't technically get money back. Instead, you just pay the reduced amount and are saving the amount you'd normally pay. If your premium comes out of your Social Security check, your payment will reflect the lower amount.

How much will be deducted from my Social Security check for Medicare in 2021?

The standard Medicare Part B premium for medical insurance in 2021 is $148.50. Some people who collect Social Security benefits and have their Part B premiums deducted from their payment will pay less.

What is the number to call for Medicare prescriptions?

If we determine you must pay a higher amount for Medicare prescription drug coverage, and you don’t have this coverage, you must call the Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE ( 1-800-633-4227; TTY 1-877-486-2048) to make a correction.

How to determine 2021 Social Security monthly adjustment?

To determine your 2021 income-related monthly adjustment amounts, we use your most recent federal tax return the IRS provides to us. Generally, this information is from a tax return filed in 2020 for tax year 2019. Sometimes, the IRS only provides information from a return filed in 2019 for tax year 2018. If we use the 2018 tax year data, and you filed a return for tax year 2019 or did not need to file a tax return for tax year 2019, call us or visit any local Social Security office. We’ll update our records.

What is MAGI for Medicare?

Your MAGI is your total adjusted gross income and tax-exempt interest income. If you file your taxes as “married, filing jointly” and your MAGI is greater than $176,000, you’ll pay higher premiums for your Part B and Medicare prescription drug coverage.

What happens if your MAGI is greater than $88,000?

If you file your taxes using a different status, and your MAGI is greater than $88,000, you’ll pay higher premiums (see the chart below, Modified Adjusted Gross Income (MAGI), for an idea of what you can expect to pay).

What is the MAGI for Social Security?

Your MAGI is your total adjusted gross income and tax-exempt interest income.

What is the standard Part B premium for 2021?

The standard Part B premium for 2021 is $148.50. If you’re single and filed an individual tax return, or married and filed a joint tax return, the following chart applies to you:

Do you pay monthly premiums for Medicare?

If you’re a higher-income beneficiary with Medicare prescription drug coverage, you’ll pay monthly premiums plus an additional amount, which is based on what you report to the IRS. Because individual plan premiums vary, the law specifies that the amount is determined using a base premium.

How much will Medicare premiums go up in 2021?

Standard Medicare premiums can, and typically do, go up from year to year. Increases from the standard premium, which is $148.50 a month in 2021, start with incomes above $88,000 for an individual and $176,000 for a couple who file taxes jointly. Updated May 13, 2021.

How to request a reduction in Medicare premium?

To request a reduction of your Medicare premium, call 800-772-1213 to schedule an appointment at your local Social Security office or fill out form SSA-44 and submit it to the office by mail or in person.

What is Social Security tax?

Social Security uses tax information from the year before last — typically the most recent data it has from the IRS — to determine if you are a “higher-income beneficiary.”. If so, you will be charged more than the “standard,” or base, premium for Medicare Part B (health insurance) and, if you have it, Part D (prescription drug coverage).

Social Security – No COLA Increase for 2010

For the year 2010, there is no Cost-Of-Living Adjustment (COLA) in Social Security benefits. This is reflected by the fact that the Consumer Price Index (CPI) had not increased for the year (as of May, when the figures are determined).

Impact to Medicare

So what does this mean for Medicare costs? Well, for most folks (about 75%) receiving Social Security, part of the news isn’t all bad: since you already receive Medicare Part A for no premium, this will not change; and your Part B premium is linked to the COLA for Social Security, so it will remain unchanged for 2010 at $96.40 per month.

Summary

All in all, this isn’t a terrible thing – of course it’s not welcome, but it could be much worse. The decision to bypass the COLA was made in May of 2009, and inflation has been pretty much benign since then. For the majority of Social Security recipients, the overall impact should be minimal.

About the author

Jim Blankenship is the founder and principal of Blankenship Financial Planning, Ltd., a financial planning firm providing hourly, as-needed financial planning and advice.

Premium pricing methods

Pricing methods define if and how your Medigap monthly premiums will increase as you age. Medigap insurance companies price policies based on one of the following structures:

Popularity

The popularity of the three pricing methods differ across the country.

Inflation and health care costs

Two additional factors that affect premiums are increases in inflation and health care costs. As the overall cost of health care rises, the insurance to cover the costs must also increase.

What is Medicare premium based on?

Medicare premiums are based on your modified adjusted gross income, or MAGI. That’s your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS. To set your Medicare cost for 2021, Social Security likely relied on the tax return you filed in 2020 that details your 2019 ...

What is the Medicare Part B rate for 2021?

If your MAGI for 2019 was less than or equal to the “higher-income” threshold — $88,000 for an individual taxpayer, $176,000 for a married couple filing jointly — you pay the “standard” Medicare Part B rate for 2021, which is $148.50 a month.

What is a hold harmless on Medicare?

If you pay a higher premium, you are not covered by “hold harmless,” the rule that prevents most Social Security recipients from seeing their benefit payment go down if Medicare rates go up. “Hold harmless” only applies to people who pay the standard Part B premium and have it deducted from their Social Security benefit.

Can you ask Social Security to adjust your premium?

You can ask Social Security to adjust your premium if a “life-changing event” caused significant income reduction or financial disruption in the intervening tax year — for example, if your marital status changed , or you lost a job , pension or income-producing property. You’ll find detailed information on the Social Security web page “Medicare ...

Do you pay Medicare Part B if you are a high income beneficiary?

If you are what Social Security considers a “higher-income beneficiary,” you pay more for Medicare Part B, the health-insurance portion of Medicare. (Most enrollees don’t pay for Medicare Part A, which covers hospitalization.) Medicare premiums are based on your modified adjusted gross income, or MAGI. That’s your total adjusted gross income ...

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9