Identification Number:
HI 01001 TN 51
Intended Audience:See Transmittal Sheet
Originating Office:Centers for Medicare & Medicaid Services (CMS)
Title:Supplementary Medical Insurance
Type:POMS Full Transmittals
Program:Medicare,Medicaid
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 010 – Premium Collections
Subchapter 01 – Supplementary Medical Insurance
Transmittal No. 51, 12/14/2022

Audience

PSC: BA, CA, CS, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, CAQCR, CCRE, CR, EIE, ERE, PETL, RECONR;
OCO-ODO: BET, BTE, CCE, CR, CST, CTE, CTE TE, DEC, DES, PAS, PETE, PETL;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

CMS

Effective Date

Upon Receipt

Background

This is a new section that introduces new policy and procedure.

Summary of Changes

HI 01001.016 Part B Immunosuppressive Drug Coverage Premium Amounts

CMS has created charts and policy for this new section.

HI 01001.016 Part B Immunosuppressive Drug (Part B-ID) Coverage Only

Beginning on January 1, 2023, certain Medicare beneficiaries, who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium.

A. Part B Immunosuppressive Drug Premium

The Part B Immunosuppressive Drug Premium in effect for 2023 - $97.10.

NOTE: Premium surcharges are not applicable to Part B-ID enrollments. However, adjustments to Part B-ID premiums can be made due to Rounding, Variable SMI, and State Buy-in.

B. Part B Immunosuppressive Drug coverage for year 2023 IRMMA sliding scale tables

The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables used to adjust Medicare Part B-ID coverage premiums. The higher the beneficiary’s range of modified adjusted income (MAGI), the higher the IRMAA.

The following are the 2023 Part B-ID monthly premium rates to be paid by (or on behalf of) beneficiaries who file individual tax returns (including those who are single, heads of households, qualifying widow(er)s with dependent children, or married individuals filing separately who lived apart from their spouses for the entire taxable year) or joint tax returns.

1. Single, head-of-household, or qualifying widow(er) with dependent child tax filing status

 

If MAGI was:

The Part B-ID IRMAA is:

The total Part B-ID monthly premium is:

More than $97,000 but less than or equal to $123,000

$64.70

$161.80

More than $123,000 but less than or equal to $153,000

$161.80

$258.90

More than $153,000 but less than or equal to $183,000

$258.90

$356.00

More than $183,000 but less than $500,000

$356.00

$453.10

More than or equal to $500,000

$388.40

$485.50

2. Married filing jointly tax filing status

 

If MAGI was:

The Part B-ID IRMAA is:

The total Part B-ID monthly premium is:

More than $194,000 but less than or equal to $246,000

$64.70

$161.80

More than $246,000 but less than or equal to $306,000

$161.80

$258.90

More than $306,000 but less than or equal to $366,000

$258.90

$356.00

More than $366,000 but less than $750,000

$356.00

$453.10

More than or equal to $750,000

$388.40

$485.50

3. Married filing separately tax filing status

 

If MAGI was:

The Part B-ID IRMAA is:

The total Part B-ID monthly premium is:

More than $97,000 but less than $403,000

$356.00

$453.10

More than or equal to $403,000

$388.40

$484.50

 


HI 01001 TN 51 - Supplementary Medical Insurance - 12/14/2022