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The Role of Income in Medicare Premium Pricing: Do Earnings Impact Your Payment Amount in 2023?

Role of Income in Medicare Premium Pricing: Do Earnings Impact Your Payment Amount in 2023

Medicare is a federal health insurance program for people aged 65 and older, as well as younger people with certain disabilities. The various parts of Medicare – Part A, Part B, Part C (Medicare Advantage), and Part D – help cover the costs of hospital care, doctor visits, and prescription drugs. However, Medicare isn’t entirely free for beneficiaries. Most people pay a monthly premium for Medicare Part B coverage, and higher earners pay more.

Medicare premiums are based on your income, so if your income goes up, you may have to pay higher Part B and Part D premiums. Let’s take a closer look at how your earnings impact what you’ll pay for Medicare coverage.

How Income Affects Your Medicare Part B Premiums

Medicare Part B helps cover medically necessary doctor visits, services, testing, and durable medical equipment. In 2023, the standard Part B premium is $164.90 per month. However, if your modified adjusted gross income (MAGI) as reported on your IRS tax return from  2021 and 2022 exceeds $97,000 if you file individually or $194,000 for a married couple filing jointly, you’ll pay more.

Here’s how it works:

  • Beneficiaries with a 2022 MAGI above $97,000 ($194,000 joint filers) pay a higher income-related monthly adjustment amount (IRMAA).

  • The IRMAA is added to the standard Part B premium. For example, if your income makes your IRMAA $75, your total amount for medicare Part B premium would be $239.90 ($164.90 + $75).

  • The IRMAA rises on a sliding scale as your income goes up. In 2023, it can add between $75-$504.90 to the standard premium.

  • The Social Security Administration uses your most recent tax return on file to determine if you’ll pay an IRMAA. Generally, this is your return from two years prior.

So if your income has increased recently, be aware you may pay higher Medicare Part B premiums. The added costs kick in as soon as the next calendar year.

Medicare Advantage Plans Can Also Cost More

Beyond original Medicare (Parts A and B), many beneficiaries enroll in Medicare Advantage plans, also known as Part C. These plans are offered by private insurers and bundle Part A, Part B, and often Part D drug coverage.

If your income exceeds $97,000 individually or $194,000 for a couple, you’ll also pay an extra premium known as the income-related monthly adjustment amount (IRMAA) for your Medicare Advantage plan.

How much extra you’ll pay depends on the specific plan. The IRMAA for Part C can range from $75-$504.90 per month in 2023. Contact your plan directly to find out if your premium will increase due to your income.

Higher Earners Also Pay More for Part D Prescription Drug Coverage

Along with Parts B and C, higher earners also pay more for Medicare Part D prescription drug coverage.

Here’s an overview:

  • The standard monthly Part D premium for 2023 is $32.74 on average, but plans can charge different amounts.

  • If your income is above $97,000 individually or $194,000 for a married couple, you may pay an extra IRMAA ranging from $5.15 to $92.35 per month.

  • This premium is charged directly by your Part D plan, not the Social Security Administration.

  • Not everyone pays this extra IRMAA. It only applies if you enroll in Part D separately from a Medicare Advantage Plan.

  • The extra Part D costs are based on the same income thresholds as Part B.

So across all parts of Medicare, higher earners pay higher premiums. Make sure to plan for these potential extra costs when budgeting for healthcare in retirement.

How Income Impacts Other Medicare Costs

Along with premiums, your income level also impacts other out-of-pocket Medicare expenses:

  • Your Part B deductible – In 2023, most people pay a $226 deductible before Part B coverage kicks in. If your income exceeds $97,000 individually or $194,000 jointly, your deductible rises to $329.

  • Coinsurance amounts – After meeting your Part B deductible, you typically pay 20% coinsurance for covered services. If you’re a higher earner, your coinsurance increases to 25-35% depending on your income.

  • Part A costs – Most people don’t pay a premium for Part A hospital coverage since they or their spouse paid Medicare taxes while working for at least 10 years. Higher earners who didn’t pay enough Medicare taxes may pay up to $578 per month for Part A in 2023.

So at all stages of Medicare, from premiums to cost sharing, charges are higher if you have more income. Always check with Medicare each year to find out if your costs will be increasing.

Steps to Take If Your Income Level Is Rising

If you expect your retirement income to trend upwards in the coming years, here are some tips:

  • Review your Medicare Part B and Part D premiums each year. Higher charges will show up on your Social Security statements.

  • Compare Medicare Advantage plans annually to find the lowest premium option for your income level. Shop plans during open enrollment each fall.

  • If your income rises above $97,000/$194,000, consider strategies to adjust your MAGI like making charitable donations or putting more money into pre-tax retirement accounts to potentially lower IRMAA costs.

  • Work with a financial advisor to maximize deductions and manage Required Minimum Distributions (RMDs) from retirement accounts in a way that minimizes the impact to your MAGI.

  • Have a tax professional review your IRS return each year to identify if you may qualify for deductions or exemptions to reduce your AGI.

With proper preparation, you can manage the higher costs that often come with having more retirement income. Stay vigilant about re-evaluating your Medicare coverage each year.

The Bottom Line

Your Medicare premium costs directly correlate to your annual income as reported to the IRS. If your income is above $97,000 as an individual or $194,000 as a couple, you’ll pay more for Medicare Parts B and D, and often for Part C Advantage plans. You can manage these extra costs by shopping Medicare plans each year, maximizing deductions, and working with a tax expert. With some diligence, you can maintain more control over your healthcare expenses in retirement.

I’m Here to Help

You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give Nick Boushay a call at (888) 508-1781. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.


How does income impact Medicare premium costs in 2023?

 Higher earners may have to pay higher premiums for Medicare in 2023. The amount you pay for Medicare Part B and Part D coverage can be based on your income level.

Will higher income individuals have to pay more for Medicare in 2023?

 Yes, individuals with higher income levels may be required to pay higher premiums for Medicare in 2023. The premiums are determined based on income brackets.

Do Medicare premiums increase based on income?

 Yes, Medicare premiums can increase based on income. Higher earners may have to pay higher monthly premiums for Medicare Part B and Part D.

Are Medicare premium costs for 2023 based on income?

 Yes, the Medicare premium costs for 2023 can vary depending on income. Individuals with higher incomes may have to pay an income-related monthly adjustment.

How are Medicare premiums determined based on income?

Medicare premiums are determined based on income reported on your tax return. The tax year used for premium calculations is usually two years prior to the premium year.

What are the income limits for Medicare premiums in 2023?

The income limits for Medicare premiums in 2023 have not been announced yet. The actual income limits for 2023 will be determined by the Centers for Medicare and Medicaid Services (CMS) and will be based on income brackets.

Are there any Medicare savings programs for individuals with higher income?

No, Medicare savings programs are generally designed to help individuals with lower income levels. Higher income individuals may not qualify for these programs.

How can I apply for Medicare savings programs?

To apply for Medicare savings programs, you can contact your local Medicaid office or your State Health Insurance Assistance Program (SHIP) office. They can provide you with more information and assist you with the application process.

Will my higher income affect my Part B costs in 2023?

 Yes, your higher income may affect your Part B costs in 2023. You may have to pay a higher Part B rate if your income exceeds certain thresholds.

Can I pay the standard Medicare premium if my income is higher?

 No, if your income is higher, you may not be eligible to pay the standard Medicare premium. You may have to pay an income-related monthly adjustment based on your income level.

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