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Carla Fried: Medicare Part B premiums headed higher for millions of retirees

Carla Fried, Rate.com on

Published in Business News

Once you’re enrolled in Medicare, the government picks up the vast majority of your medical bills. But not all. And the cost of a key part of Medicare coverage is expected to cost higher-income households significantly more in the coming years.

Medicare Part B means testing

Nearly all enrollees are required to pay a monthly premium for Medicare Part B coverage. Part B is the core insurance that pays for doctor visits, tests and treatment. (Low-income individuals are exempt from paying the premium.)

Up until 2007 there was one flat Part B premium: 25% of what Medicare expects the overall program will pay for services provided under Part B. The federal government picks up the other 75%.

But to help address revenue problems, the Medicare program started tacking on an additional premium charge for higher income households.

Higher income retirees pay between 35% and 85% of the program’s projected outlays for Part B services. This extra surcharge is the income related monthly adjusted amount (IRMAA).

Last year, about 5 million Medicare beneficiaries paid an IRMAA surcharge. And the official estimate from the Medicare program is that by 2029, more than 10 million beneficiaries will pay extra for Part B. And we’re not talking small potatoes. Medicare estimates that the extra monthly charges could add $90 or so at the low end, to more than $500 a month more for the very wealthy.

The lowest Part B premium

Part B premiums are set each year. The lowest Part B premium in 2021 is $148.50 per month.

In a byzantine system, current year premiums are based on the income reported on tax returns from two years prior. That is, 2021 premiums are based on 2019 modified adjusted gross income, or MAGI, (all your income + any income from municipal bonds). In 2022, premiums will be based on 2020 reported income.

An individual with 2019 MAGI below $88,000 and married couples filing a joint return with 2019 MAGI below $176,000 pay the base rate of $148.50.

The Medicare Part B surcharge

If your income is higher than $88,000/$176,000 in 2021, you pay more for Part B. Here’s the breakdown for 2021:

 

$207.90 per person monthly premium: Individuals with 2019 income above $88,000 and up to $111,000, and married couples with income above $176,000 and up to $222,000

$297.00 per person monthly premium: Individuals with 2019 income above $111,000 and up to $138,000, and married couples filing a joint return with income above $222,000 and up to $276,000.

$386.10 per person monthly premium: Individuals with 2019 income above $138,000 and up to $165,000, and married couples filing a joint return with income above $276,000 and up to $330,000.

$475.20 per person monthly premium: Individuals with 2019 income above $165,000 and less than $500,000, and married couples filing a joint return with income above $330,000 and less than $750,000.

Higher income households pay even more. The top 2021 Part B monthly premium of $504.90 is levied on individuals who had income of $500,000 or more in 2019, and married couples with income of at least $750,000.

IRMAA’s growing footprint and cost

Medicare estimates that the standard monthly Part B premium that is $148.50 this year could be more than $230 in 2029.

And as the tail end of the Baby Boomer generation hits 65, record numbers of enrollees will be in the crosshairs of the extra premium costs. And those extra costs are expected to be much higher as well.

This year, individuals in the first tier above the base rate pay an extra $59.40 a month ($207.90 to $148.50). By 2029, Medicare’s intermediate estimate is that the extra surcharge could be more than $90 a month per person for people in this payment tier.

Someone in the second tier above the base rate pays an extra $148.50 a month this year ($297.00 to $148.50). By 2029, the extra charge could be more than $230 a month per person, according to Medicare estimates.

Time to play catchup?

If all that just motivated you to save a bit more for retirement, keep in mind that the government gives the 50+ crowd leeway to stuff away more than younger folks. This year, anyone at least 50 can save up to $7,000 in an IRA, compared to the $6,000 limit for younger savers. And if you participate in a workplace retirement 401(k), you can contribute up to $26,000 this year if you are at least 50; that’s $6,500 more than what your younger colleagues are allowed to save.

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