Medicare premiums and your income

We all know that Medicare is not free. Once we enroll in Part “B”, and “D”, we start paying monthly premiums. What many consumers fail to realize is that how much you pay depends upon how much you make.

For most of us, this is a moot point. We assume that we will be retiring at 65 years old (at the same time Medicare kicks in) but that assumption is no longer accurate. The reality is that Social Security, retirement, and Medicare can happen at different times in your life.

Take, for example, Social Security benefits. Every year the target date for full retirement creeps higher. It used to be 65, but now, for many, it is edging up to almost 67 over the next few years. When that occurs, a worker will usually sign up for Medicare “A” but delay enrolling in Parts “B” and “D” until after they retire and are no longer covered by their company’s health insurance program.

What most applicants don’t know, until it is too late, is that your monthly Medicare premiums will be based on your last two years’ annual income. But the actual logistics of that can be confusing. Here’s why.

Your reported income follows a governmental processing chain where once the IRS processes your tax returns, they pass that information on to Social Security, which, in turn, feeds the data to Medicare, which then determines your premiums based on those numbers.

Let’s say you are applying for Medicare “B” and “D” right now. For starters, most of us are just now filing our tax returns for 2017 (even though we are already approaching the second quarter of 2018). It will take months before the IRS gives Social Security your 2017 tax returns, and even more time before that data gets to Medicare. Bottom line: there is a big-time lag between your current income and when it shows up in your Medicare premiums.

That means if you are retiring now and made less than $85,000 (as a single taxpayer or $170,000 filing jointly) in the calendar year 2016, your premiums would qualify at the base rate of $134/month for Part “B” and $13/month for Part “D”.

Above that income level, your premiums increase to $267.90 and $33.60, if you make over $85,000-$107,000 ($170,000-$214,000 jointly). They jump again above $133,500 or $267,000 jointly. And again, and again, until you can be paying as much as $428.60 and $74.80 per month when your income exceeds $160,000 or $320,000 jointly. If your spouse is also retired and on Medicare, then double that premium amount. For those couples making above $320,000/year, for example, they will be paying $503.40 per month or $6,040.80 a year.

Social Security determines what you pay each year, based on your modified adjusted gross income (MAGI) as reported to the IRS. MAGI would include things like wages, dividends, rental income, capital gains and non-taxable Social Security benefits. If you earn more (or less) the following year, Social Security will adjust your monthly premiums. They call it your income-related monthly adjusted amount. That premium will be deducted from your Social Security income check or, if you are not taking Social Security yet, it will be billed to you.

Theoretically, your premiums should be adjusted every year with a lag. So, if you report a high-income number to the IRS for the two years prior to retirement, you can expect to pay a lot in Medicare premiums. What happens when your income drops, as it usually does once you retire?

You can petition for a Request for Reconsideration to reduce your Part B premium, if you feel there is a compelling reason why you should not be paying a higher premium. The most common reason most petition is that income has dropped dramatically in retirement. Other reasons might include marriage, divorce or being widowed. The loss of income-producing property and changes or termination of a pension would also count.

Appeals work some of the time, but not all the time. It is a lengthy process and you still must pay your premiums while the petition makes its tortuous way through this process. It costs nothing to petition, however, and you might win in the end.

A much better approach, if you can manage it, is to reduce your income as much as possible two years prior to signing up for Medicare “B” and “D”. That is not always easy to pull off. You might reduce your hours and compensation, for example, if your employer is flexible, or, if your spouse works, and has family health coverage, you could retire, delay Medicare coverage for two years, and then apply. It comes down to what you can afford to give up now for future benefits in the years ahead.