TN 7 (02-18)

HI 01101.020 IRMAA Sliding Scale Tables

Citations:

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 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.

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. Medicare Part B and Part D Prescription Drug coverage for year 2018 IRMAA tables

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

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 $107,000

$187.50

$13.00

+ Plan premium

More than $107,000 but less than or equal to $133,500

$267.90

$33.60

+ Plan premium

More than $133,500 but less than or equal to $160,000

$348.30

$54.20

+ Plan premium

More than $160,000

$428.60

$74.80

+ Plan premium

2. Married filing jointly tax filing status

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 $170,000 but less than or equal to $214,000

$187.50

$13.00

+ Plan premium

More than $214,000 but less than or equal to $267,000

$267.90

$33.60

+ Plan premium

More than $267,000 but less than or equal to $320,000

$348.30

$54.20

+ Plan premium

More than $320,000

$428.60

$74.80

+ Plan premium

3. Married filing separately tax filing status

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

$428.60

$74.80

+ Plan premium

* Plus all applicable surcharges, minus Medicare Advantage Reduction. (For Medicare Advantage Reduction, see SM 03040.335.)

**Plus late enrollment or reenrollment fees for prescription drug coverage.

NOTE: 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.

C. IRMAA tables of Medicare Part B premium year for three previous years

IRMAA Table

2017

2016

2015

MAGI (based on tax return two years prior, or three years if two years prior is unavailable)

Part B*

Part B*

Part B*

Single, head-of-household, or qualifying widow(er) with dependent child

   

More than $85,000 but less than or equal to $107,000

$187.50

$170.50

$146.90

More than $107,000 but less than or equal to $160,000

$267.90

$243.60

$209.80

More than $160,000 but less than or equal to $214,000

$348.30

$316.70

$272.70

More than $214,000

$428.60

$389.80

$335.70

Married filing jointly

   

More than $170,000 but less than or equal to $214,000

$187.50

$170.50

$146.90

More than $214,000 but less than or equal to $320,000

$267.90

$243.60

$209.80

More than $320,000 but less than or equal to $428,000

$348.30

$316.70

$272.70

More than $428,000

$428.60

$389.80

$335.70

Married filing separately

   

More than $85,000 but less than or equal to $129,000

$348.30

$316.70

$272.70

More than $129,000

$428.60

$389.80

$335.70

* Plus any applicable surcharges, minus any Medicare Advantage Reduction. (For Medicare Advantage Reduction, see SM 03040.335.)

NOTE: 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.

D. IRMAA tables of Part D Prescription Drug coverage premium year for three previous premium years

IRMAA Table

2017

2016

2015

MAGI (based on tax return two years prior, or three years prior if two years prior is unavailable)

Prescription Drug Coverage Premium **

Prescription Drug Coverage Premium **

Prescription Drug Coverage Premium **

Single, head-of-household, or qualifying widow(er) with dependent child

   

More than $85,000 but less than or equal to $107,000

$13.30

+ Plan premium

$12.70

+ Plan premium

$12.30

+ Plan premium

More than $107,000 but less than or equal to $160,000

$34.20

+ Plan premium

$32.80

+ Plan premium

$31.80

+ Plan premium

More than $160,000 but less than or equal to $214,000

$55.20

+ Plan premium

$52.80

+ Plan premium

$51.30

+ Plan premium

More than $214,000

$76.20

+ Plan premium

$72.90

+ Plan premium

$70.80

+ Plan premium

Married filing jointly

   

More than $170,000 but less than or equal to $214,000

$13.30

+ Plan premium

$12.70

+ Plan premium

$12.30

+ Plan premium

More than $214,000 but less than or equal to $320,000

$34.20

+ Plan premium

$32.80

+ Plan premium

$31.80

+ Plan premium

More than $320,000 but less than or equal to $428,000

$55.20

+ Plan premium

$52.80

+ Plan premium

$51.30

+ Plan premium

More than $428,000

$76.20

+ Plan premium

$72.90

+ Plan premium

$70.80

+ Plan premium

Married filing separately

   

More than $85,000 but less than or equal to $129,000

$55.20

+ Plan premium

$52.80

+ Plan premium

$51.30

+ Plan premium

More than $129,000

$76.20

+ Plan premium

$72.90

+ Plan premium

$70.80

+ Plan premium

**Plus late enrollment or reenrollment fees for prescription drug coverage.

NOTE: 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.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0601101020
HI 01101.020 - IRMAA Sliding Scale Tables - 04/06/2018
Batch run: 04/06/2018
Rev:04/06/2018