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HI 01101.020: IRMAA Sliding Scale Tables

changes
← * →
  • Effective Dates: 11/23/2016 - Present
  • Effective Dates: 02/20/2018 - Present
  • TN 3 (11-10)
  • TN 7 (02-18)
  • HI 01101.020 IRMAA Sliding Scale Tables
  • Citations:
  • Sections 1839(i) and 1860D-13(i) of the Social Security Act
  • 1839(i) and 1860D-13(i) Sections of the Social Security Act
  • 20 CFR 418.1115 and 418.2115
  • A. Policy for IRMAA Medicare Part B and prescription drug coverage premiums sliding scale tables
  • The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables to adjust Medicare Part B and prescription drug coverage premiums. The higher the beneficiary’s range of modified adjusted gross income (MAGI), the higher the IRMAA will be. There are three sets of tables. Each table is based on the beneficiary’s tax filing status.
  • The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables used to adjust Medicare Part B and Part D prescription drug coverage premiums. The higher the beneficiary’s range of modified adjusted gross income (MAGI), the higher the IRMAA. There are three sets of tables. Use the beneficiary’s tax filing status when using the table.
  • NOTE: The IRMAA screens contain a calculator which takes all the factors, such as filing status, sliding scale, and premium year into account so that an estimate can be provided to the beneficiary upon request. (See MSOM T2PE 008.013, Income Related Monthly Adjustment Amount Calculator (IRCA)).
  • The IRMAA screens contain a calculator that takes all the IRMAA determination factors such as filing status, sliding scale, and premium year into account to provide an estimate to the beneficiary upon request. (See Income Related Monthly Adjustment Amount Calculator (IRCA)) MS T2PE 008.013.
  • B. IRMAA tables, Medicare Part B premium year 2017
  • B. Medicare Part B and Part D Prescription Drug coverage for year 2018 IRMAA tables
  • 1. Tax filing status: single, head–of–household or qualifying widow(er) with dependent child
  • 1. Single, head–of–household, or qualifying widow(er) with dependent child tax filing status
  • If MAGI in 2015 (or 2014 if 2015 is not available) was:
  • If MAGI in 2016 (or 2015 if 2016 is not available) was:
  • Then the Part B Premium* is:
  • Prescription Drug
  • Coverage Premium** is:
  • Prescription Drug Coverage Premium** is:
  • More than $85,000 but less than or equal to $107,000
  • $187.50
  • $13.30
  • $13.00
  • + Plan premium
  • + Part B premium
  • More than $107,000 but less than or equal to $160,000
  • More than $107,000 but less than or equal to $133,500
  • $267.90
  • $34.20
  • $33.60
  • + Plan premium
  • + Part B premium
  • More than $160,000 but less than or equal to $214,000
  • More than $133,500 but less than or equal to $160,000
  • $348.30
  • $55.20
  • $54.20
  • + Plan premium
  • + Part B premium
  • More than $214,000
  • More than $160,000
  • $428.60
  • $76.20
  • $74.80
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • + Part B premium
  • 2. Tax filing status: married, filing jointly
  • 2. Married filing jointly tax filing status
  • If MAGI in 2015 (or 2014 if 2015 is not available) was:
  • If MAGI in 2016 (or 2015 if 2016 is not available) was:
  • Then the Part B Premium* is:
  • Prescription Drug
  • Coverage Premium** is:
  • Prescription Drug Coverage Premium** is:
  • More than $170,000 but less than or equal to $214,000
  • $187.50
  • $13.30
  • $13.00
  • + Plan premium
  • + Part B premium
  • More than $214,000 but less than or equal to $320,000
  • More than $214,000 but less than or equal to $267,000
  • $267.90
  • $34.20
  • $33.60
  • + Plan premium
  • + Part B premium
  • More than $320,000 but less than or equal to $428,000
  • More than $267,000 but less than or equal to $320,000
  • $348.30
  • $55.20
  • $54.20
  • + Plan premium
  • + Part B premium
  • More than $428,000
  • More than $320,000
  • $428.60
  • $76.20
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • $74.80
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage
  • + Part B premium
  • 3. Tax filing status: married, filing separately
  • 3. Married filing separately tax filing status
  • If MAGI in 2015 (or 2014 if 2015 is not available) was:
  • If MAGI in 2016 (or 2015 if 2016 is not available) was:
  • Then the Part B Premium* is:
  • Prescription Drug
  • Coverage Premium** is:
  • More than $85,000 but less than or equal to $129,000
  • $348.30
  • $55.20
  • + Plan premium
  • Prescription Drug Coverage Premium** is:
  • More than $129,000
  • More than $85,000
  • $428.60
  • $76.20
  • + Plan premium
  • C. IRMAA tables, Medicare Part B premium year 2016
  • 1. Tax filing status: single, head–of–household or qualifying widow(er) with dependent child
  • If MAGI in 2014 (or 2013 if 2014 is not available) was:
  • Then the Part B Premium* is:
  • Prescription Drug
  • Coverage Premium** is:
  • More than $85,000 but less than or equal to $107,000
  • $170.50
  • $12.70
  • + Plan premium
  • More than $107,000 but less than or equal to $160,000
  • $74.80
  • + Part B premium
  • * Plus all applicable surcharges, minus Medicare Advantage Reduction. (For Medicare Advantage Reduction, see SM 03040.335.)
  • $243.60
  • **Plus late enrollment or reenrollment fees for prescription drug coverage.
  • When the Internal Revenue Service (IRS) provides us the tax filing status of married filing separately, assume the couple lived together at some point in the tax year. The law provides higher IRMAA levels for beneficiaries in this situation. If one or both members of the couple allege that they lived apart throughout the entire tax year, see HI 01120.060.
  • $32.80
  • C. IRMAA tables of Medicare Part B premium year for three previous years
  • + Plan premium
  • More than $160,000 but less than or equal to $214,000
  • IRMAA Table
  • $316.70
  • 2017
  • $52.80
  • 2016
  • + Plan premium
  • 2015
  • More than $214,000
  • MAGI (based on tax return two years prior, or three years if two years prior is unavailable)
  • $389.80
  • Part B*
  • $72.90
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • 2. Tax filing status: married, filing jointly
  • Part B*
  • If MAGI in 2014 (or 2013 if 2014 is not available) was:
  • Part B*
  • Then the Part B Premium* is:
  • Single, head-of-household, or qualifying widow(er) with dependent child
  •  
  •  
  •  
  • Prescription Drug
  • Coverage Premium** is:
  • More than $85,000 but less than or equal to $107,000
  • More than $170,000 but less than or equal to $214,000
  • $187.50
  • $170.50
  • $12.70
  • + Plan premium
  • More than $214,000 but less than or equal to $320,000
  • $243.60
  • $146.90
  • $32.80
  • + Plan premium
  • More than $107,000 but less than or equal to $160,000
  • $267.90
  • More than $320,000 but less than or equal to $428,000
  • $243.60
  • $316.70
  • $209.80
  • $52.80
  • + Plan premium
  • More than $160,000 but less than or equal to $214,000
  • More than $428,000
  • $348.30
  • $389.80
  • $316.70
  • $72.90
  • $272.70
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage
  • 3. Tax filing status: married, filing separately
  • More than $214,000
  • $428.60
  • If MAGI in 2014 (or 2013 if 2014 is not available) was:
  • $389.80
  • Then the Part B Premium* is:
  • $335.70
  • Prescription Drug
  • Coverage Premium** is:
  • Married filing jointly
  •  
  •  
  •  
  • More than $85,000 but less than or equal to $129,000
  • More than $170,000 but less than or equal to $214,000
  • $316.70
  • $187.50
  • $52.80
  • $170.50
  • + Plan premium
  • $146.90
  • More than $129,000
  • More than $214,000 but less than or equal to $320,000
  • $389.80
  • $267.90
  • $72.90
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • $243.60
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage.
  • NOTE: When the Internal Revenue Service (IRS) provides the Social Security Administration (SSA) with the tax filing status of Married Filing Separately, SSA assumes the couple lived together at some point in the tax year. The law provides that beneficiaries in this situation are subject to higher IRMAA levels. If one or both of the members allege they lived apart throughout the entire tax year, see HI 01120.060.
  • $209.80
  • D. IRMAA tables, Medicare Part B premium year 2015
  • 1. Tax filing status: single, head–of–household or qualifying widow(er) with dependent child
  • More than $320,000 but less than or equal to $428,000
  • $348.30
  • If MAGI in 2013 (or 2012 if 2013 is not available) was:
  • $316.70
  • Then the Part B Premium* is:
  • $272.70
  • Prescription Drug
  • Coverage Premium** is:
  • More than $428,000
  • More than $85,000 but less than or equal to $107,000
  • $428.60
  • $146.90
  • $389.80
  • $12.10
  • $335.70
  • + Plan premium
  • Married filing separately
  •  
  •  
  •  
  • More than $107,000 but less than or equal to $160,000
  • $209.80
  • $31.80
  • More than $85,000 but less than or equal to $129,000
  • + Plan premium
  • $348.30
  • More than $160,000 but less than or equal to $214,000
  • $316.70
  • $272.70
  • $51.30
  • + Plan premium
  • More than $129,000
  • More than $214,000
  • $428.60
  • $335.70
  • $389.80
  • $70.80
  • $335.70
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (For Medicare Advantage Reduction, see SM 03040.335.)
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • When the Internal Revenue Service (IRS) provides us with the tax filing status of married filing separately, assume the couple lived together at some point in the tax year. The law provides higher IRMAA levels for beneficiaries in this situation. If one or both members of the couple allege that they lived apart throughout the entire tax year, see HI 01120.060.
  • 2. Tax filing status: married, filing jointly
  • D. IRMAA tables of Part D Prescription Drug coverage premium year for three previous premium years
  • If MAGI in 2012 (or 2011 if 2012 is not available) was:
  • Then the Part B Premium* is:
  • IRMAA Table
  • Prescription Drug
  • 2017
  • Coverage Premium** is:
  • 2016
  • More than $170,000 but less than or equal to $214,000
  • 2015
  • $146.90
  • MAGI (based on tax return two years prior, or three years prior if two years prior is unavailable)
  • $12.30
  • + Plan premium
  • Prescription Drug Coverage Premium **
  • Prescription Drug Coverage Premium **
  • More than $214,000 but less than or equal to $320,000
  • Prescription Drug Coverage Premium **
  • $209.80
  • $31.10
  • Single, head-of-household, or qualifying widow(er) with dependent child
  •  
  •  
  •  
  • + Plan premium
  • More than $85,000 but less than or equal to $107,000
  • More than $320,000 but less than or equal to $428,000
  • $13.30
  • $272.70
  • + Part B premium
  • $51.30
  • $12.70
  • + Plan premium
  • + Part B premium
  • $12.30
  • More than $428,000
  • + Part B premium
  • $335.70
  • More than $107,000 but less than or equal to $160,000
  • $70.80
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • $34.20
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage
  • + Part B premium
  • 3. Tax filing status: married, filing separately
  • $32.80
  • + Part B premium
  • If MAGI in 2011 (or 2010 if 2011 is not available) was:
  • $31.80
  • + Part B premium
  • Then the Part B Premium* is:
  • Prescription Drug
  • More than $160,000 but less than or equal to $214,000
  • Coverage Premium** is:
  • $55.20
  • + Part B Plan premium
  • More than $85,000 but less than or equal to $129,000
  • $52.80
  • $272.70
  • + Part B premium
  • $51.30
  • + Plan premium
  • More than $129,000
  • $335.70
  • $70.80
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage.
  • NOTE: When the Internal Revenue Service (IRS) provides the Social Security Administration (SSA) with the tax filing status of Married Filing Separately, SSA assumes the couple lived together at some point in the tax year. The law provides that beneficiaries in this situation are subject to higher IRMAA levels. If one or both of the members allege they lived apart throughout the entire tax year, see HI 01120.060.
  • E. IRMAA tables, Medicare Part B premium year 2014
  • 1. Tax filing status: single, head–of–household or qualifying widow(er) with dependent child
  • + Part B premium
  • More than $214,000
  • If MAGI in 2012 (or 2011 if 2012 is not available) was:
  • Then the Part B Premium* is:
  • Prescription Drug
  • Coverage Premium** is:
  • More than $85,000 but less than or equal to $107,000
  • $146.90
  • $12.10
  • + Plan premium
  • More than $107,000 but less than or equal to $160,000
  • $209.80
  • $76.20
  • $31.10
  • + Part B premium
  • + Plan premium
  • $72.90
  • + Part B premium
  • More than $160,000 but less than or equal to $214,000
  • $70.80
  • $272.70
  • + Part B premium
  • $50.20
  • + Plan premium
  • Married filing jointly
  •  
  •  
  •  
  • More than $214,000
  • More than $170,000 but less than or equal to $214,000
  • $335.70
  • $13.30
  • + Part B premium
  • $69.30
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • $12.70
  • 2. Tax filing status: married, filing jointly
  • + Part B premium
  • If MAGI in 2012 (or 2011 if 2012 is not available) was:
  • $12.30
  • + Part B premium
  • Then the Part B Premium* is:
  • Prescription Drug
  • More than $214,000 but less than or equal to $320,000
  • Coverage Premium** is:
  • $34.20
  • + Part B premium
  • More than $170,000 but less than or equal to $214,000
  • $32.80
  • $146.90
  • + Part B premium
  • $12.10
  • $31.80
  • + Plan premium
  • + Part B premium
  • More than $214,000 but less than or equal to $320,000
  • More than $320,000 but less than or equal to $428,000
  • $209.80
  • $55.20
  • + Part B premium
  • $29.90
  • + Plan premium
  • $52.80
  • + Part B premium
  • More than $320,000 but less than or equal to $428,000
  • $51.30
  • + Part B premium
  • $272.70
  • $50.20
  • More than $428,000
  • + Plan premium
  • $76.20
  • + Part B premium
  • More than $428,000
  • $72.90
  • $335.70
  • + Part B premium
  • $69.30
  • $70.80
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • + Part B premium
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage
  • 3. Tax filing status: married, filing separately
  • Married filing separately
  •  
  •  
  •  
  • If MAGI in 2012 (or 2011 if 2012 is not available) was:
  • More than $85,000 but less than or equal to $129,000
  • Then the Part B Premium* is:
  • $55.20
  • + Part B premium
  • Prescription Drug
  • Coverage Premium** is:
  • $52.80
  • + Part B premium
  • More than $85,000 but less than or equal to $129,000
  • $51.30
  • + Part B premium
  • $272.70
  • $50.20
  • More than $129,000
  • + Plan premium
  • $76.20
  • + Part B premium
  • More than $129,000
  • $72.90
  • $335.70
  • + Part B premium
  • $69.30
  • $70.80
  • + Plan premium
  • * Plus any applicable surcharges, minus any Medicare Advantage Reduction. (See SM 03040.335 for Medicare Advantage Reduction)
  • + Part B premium
  • **Plus any late enrollment or reenrollment fees for prescription drug coverage.
  • **Plus late enrollment or reenrollment fees for prescription drug coverage.
  • NOTE: When the Internal Revenue Service (IRS) provides the Social Security Administration (SSA) with the tax filing status of Married Filing Separately, SSA assumes the couple lived together at some point in the tax year. The law provides that beneficiaries in this situation are subject to higher IRMAA levels. If one or both of the members allege they lived apart throughout the entire tax year, see HI 01120.060.
  • When the Internal Revenue Service (IRS) provides us with the tax filing status of married filing separately, assume the couple lived together at some point in the tax year. The law provides higher IRMAA levels to beneficiaries in this situation. If one or both members of the couple allege that they lived apart throughout the entire tax year, see HI 01120.060.
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