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Here’s a fact that might surprise you: Medicare does not determine eligibility based on income. Rather, Medicare eligibility is determined based on age and disability. You are eligible for Medicare if either one of the following is true:
If you fit into either of these categories, then you’re eligible to receive Medicare benefits, regardless of how much income you make. But there’s more that you should know about when it comes to Medicare. Keep reading to find out.
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Of course, that answer is too simple to be the full story. While eligibility is not affected by how much money you make, there are Medicare costs based on income—your premiums.
Those who make over a certain amount must pay more for their premiums, and those that earn less than a certain limit can qualify for discounts.
The rest of this article will explain the fluctuations in Medicare premiums for the year 2023 in three simple parts:
Let’s dive in.
First thing’s first: what the heck is an IRMAA?
Basically, this acronym refers to the additional cost that a person who makes over the limit for Medicare pays each month. Because Part A is usually free and Medicare Advantage (Part C) is varied, IRMAAs only apply to Medicare Part B and Part D.
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The Social Security Administration (SSA) bases IRMAAs on your yearly income reported on tax returns from two years ago. This means that the 2023 IRMAAs are based on tax returns from 2021.
The SSA will send you a letter if an IRMAA is required of you.
An IRMAA does not require an additional payment step. Rather, the amounts are simply added to your normal Medicare premiums which are paid via either:
What will that bill be? Keep reading.
The limits and amounts typically increase each year. As of 2023, these are the Medicare income limits and IRMAAs for Parts B and C:
Yearly Income: Single | Yearly Income: Married | Part B Monthly IRMAA | Part D Monthly IRMAA |
Less than $97,000 | Less than 194,000 | None | None |
Between $97,000 and $123,000 | Between 194,000 and $246,000 | $65.90 | $12.20 |
Between $123,000 and $153,000 | Between $246,000 and $306,000 | $164.80 | $32.50 |
Between $153,000 and $183,000 | Between $306,000 and $366,000 | $263.70 | $50.70 |
Between $183,000 and $500,000 | Between $366,000 and $750,000 | $362.60 | $70.00 |
Over $500,000 | Over $750,000 | $395.60 | $76.40 |
As you can see, your income has a significant impact on what you could pay. But if your amount seems off, there are steps you can take. More on that next.
Good news: it is possible to appeal IRMAAs if you believe that you are paying them unjustly, or if there has been a recent change to your financial situation.
You can appeal by filling out a form and providing supporting documentation to the Social Security Association (SSA) in any of the given circumstances:
Filling out the form and providing as much detail as you can will better your chances of having your appeal granted.
There are four different Medicare Savings Programs that can reduce the amount you pay for Medicare. Each one works a little differently.
Before we begin, a quick note: the Medicare income limits are higher in the states of Alaska and Hawaii.
Qualified Medicare Beneficiary
Eligible individuals:
Eligible married couples:
This savings program covers the cost of all premiums, deductibles, copayments, and coinsurance associated with Original Medicare.
Specified Low-Income Medicare Beneficiary
Eligible individuals:
Eligible married couples:
This savings program covers the entire costs of Part B and ensures that you pay no more than $9.85 per prescription drug in Part D.
Qualifying Individual
Eligible individuals:
Eligible married couples:
This savings plan must be reapplied for yearly. There are limited spots available, so it is only offered on a first come, first served basis.
The plan covers the entire costs of Part B and ensures that you pay no more than $9.85 per prescription drug in Part D.
Qualifying Disabled Working Individual
Eligible individuals:
Eligible married couples:
This savings plan is for those who receive Medicare on the basis of a disability, are under the age of 65, and are working. This plan covers Part A.
This was a lot of information, but that’s a good thing: the more informed you are, the better you become at saving money on insurance.
Here’s the gist: There are no Medicare limits on income to qualify for the federal program. But while there’s no income limit for Medicare eligibility, you could end up paying higher premiums the more you make.
Remember, ConsumerCoverage is here to help every step of the way of your health insurance journey. Click here to get access to free quotes or to talk to a friendly insurance agent about your Medicare needs. We’ve got you covered.
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Hollay Ghadery Hollay Ghadery is a writer and editor who is passionate about financial literacy as a means to personal fulfillment. Hollay has over 18 years of experience creating content about a range of topics related to personal finance, including insurance, investing, banking, and credit cards. When Hollay isn't writing, she's spending time with her four children, two dogs, and three goats.