TN 3 (11-10)

Citations:

Section 1839(i) of the Social Security Act;

20 CFR 418.1010 , 418.1101 , 418.1110 , 418.1115 , 418.2010 , 418.2101 , 418.2110 , and 418.2115

A. Policy for MAGI

1. Modified Adjusted Gross Income (MAGI) is the sum of:

   • the beneficiary’s adjusted gross income (AGI) (found on the last line of page 1 of the Internal Revenue Service (IRS) tax filing form), plus

   • tax-exempt interest income (line 8b of IRS Form 1040).

2. The MAGI used to determine if the income-related monthly adjustment amount (IRMAA) applies is the most recent tax information that IRS is able to provide. Generally, the information is from two years prior to the year for which the premium is being determined, but not more than three years prior. For example, 2011 premiums are generally based on 2009 tax return information. See HI 01101.020 for more detail about how MAGI is used.

3. Beneficiaries with Medicare Part B, prescription drug coverage, or both, with MAGI above the applicable threshold pay more toward their coverage premiums because of IRMAA. See the policy for MAGI thresholds in HI 01101.010B.

4. Beneficiaries with MAGI above the threshold are subject to a sliding scale increase in their premiums. See HI 01101.020, IRMAA Sliding Scale Tables.

B. Policy for MAGI thresholds

The MAGI thresholds used for IRMAA calculations are: