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Medicare IRMAA 2024

Agents need to understand what the Medicare IRMAA 2024 will be in order to advise their clients accordingly.

IRMAA explained

IRMAA is an additional charge that may be added to a beneficiaries Medicare Part B and or Medicare Part D premium.  An IRMAA applies to certain individuals whose income level is above a pre-determined amount.  Income amounts are decided annually on a sliding scale and include 5 different income brackets.   If the Social Security administration determines a client must pay an IRMAA, they will send a premium notice that includes an explanation of the charge.

The IRMAA amounts are based on the beneficiaries’ income from 2 years before the present year.  For example: a 2024 IRMAA is based on the beneficiary’s income from 2022.  Because income changes from year to year, the IRMAA amount can also change accordingly.

Determination of both Part B and Part D total premiums can be calculated by adding the current Part B premium ($174.70 in 2024) to your IRMAA amount.  This works the same way for your current Part D IRMAA amount and premium.

Part B & Part D IRMAA income brackets & surcharge amounts 2024

Please note:  The IRMAA for married Medicare beneficiaries who file separate tax returns are higher if they lived together for any amount of the year.

How to make your Medicare IRMAA 2024 payment

Because there are 2 separate IRMAAs (Part B & Part D) the payments are handled differently. The IRMAA for Part B is added to your monthly premium bill automatically.

Part B IRMAA

Here are a few ways to pay your Part B IRMAA

1. Send your payment to Medicare through the mail. You can send either a check, money order or credit or debit card information by filling out the coupon attached to the bottom of your bill. If you are sending payment without the coupon, be sure to put your Medicare number in the memo of the check.  Send payments in the return envelope that comes with your invoice and mail payments to Medicare Premium Collection Center, P.O. Box 790355, St Louis , MO 63179-0355.
2. The quickest way to pay is online with your secure Medicare account.  You can use a credit or debit card or pay through either your checking or savings account.
3. Use Medicare Easy Pay to have Medicare deduct your premiums from your savings or checking directly each month.  Please note; it can take up to 8 weeks for automatic deductions to begin.  Be sure you pay the premiums another way until it is set up.  You can also use your bank’s online bill payment service if they offer one.

Part D IRMAA

On the other hand, you must pay the IRMAA for Part D directly to Medicare.  The beneficiary must pay it even if their employer or a third party (e.g., retirement system) pays their Part D premiums. They receive a monthly bill from Medicare for the Part D IRMAA.  This amount can be paid using the same method used to pay for their Part B premium.

Usually, beneficiaries receive the bill the same month it is due.  The premiums are always due on the 25th of each month. In the event that you miss a payment, or it is sent in late, it will be included with the next bill.

Medicare IRMAA 2024- how to request a redetermination

The SSA (Social Security Administration) bases their determination of who owes an IRMAA on the income reported on tax returns from the  2 years before you pay the IRMAA.  If SSA does decide you owe an IRMAA, they send you an initial determination notice.  When you receive this notice, you will also get information explaining how to request a new initial determination.

If Social Security receives a new initial determination, they may revise the amount owed or take the IRMAA away all together.  To request the redetermination, either schedule an appointment with your local Social Security office or submit the following form:

Medicare IRMAA Life-Changing Event form

You need to provide documentation of your correct income or of the life-changing event that has affected your income level in a negative way.

Here are examples of acceptable life-changing events:

1. Death of a spouse, a divorce or annulment or a marriage
2. If either spouse stops or reduces the number of hours they work
3. When either spouse loses a pension
4. Loss of income due to income producing property loss because of a natural disaster, fraud or similar circumstances

If you had an amended tax return, you can call the representatives at SSA +1 800-772-1213 and say you want to lower your (IRMAA) Medicare Income-Related Monthly Adjustment Amount.   Use the fact that Social Security used outdated or incorrect information when calculating your IRMAA.

Learn about the 2024 Social Security increase

Find out what the effects of the 2025 drug cap will be

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Assisted Living FAQs

Because many people have questions about assisted living, we are providing answers to the most asked Assisted living FAQs in the post below.

What is an assisted living facility:

Assisted living facilities provide individuals assistance with the ADLs (activities of daily living).  These activities include; meal preparation, bathing, dressing as well as medication management to name a few.  All these activities are categorized as custodial care.

Click here to learn more about the activities of daily living

What is the difference between Medicaid and Medicare in assisted living coverage:

There are definitely difference in how Medicare and Medicaid provide coverage for assisted living.

1.  Medicare does not provide any coverage for assisted living facilities. Although it does short-term stays in a skilled nursing facility for rehabilitation purposes as long as specific requirements are met.  This criterion includes the exclusion of the need for long-term care.
2. In some states, qualified Medicaid enrollees may receive help from a waiver program they provide with the costs for personal care as well as some other support services beneficiaries receive in an assisted living setting.  This assistance can reduce the total cost of assisted living quite a bit.  However, Medicaid does not offer help with the costs of room and board in an assisted living facility.

Click here for more details on Assisted living coverage

Is there a way to get financial assistance for assisted living:

As stated above, several states provide help with assisted living costs for anyone who has limited financial resources and qualifies for help such as Medicaid.

Veterans may qualify for help through programs offered through their local VA.  These programs and VA benefits may offer help with the costs of assisted living.

Although Medicare does not cover assisted living facilities, it will cover cost for medical treatment provided by doctors or hospitals as well as some approved skilled nursing facility care. If prescription drugs are needed, they are covered by Medicare Part D.

Does Medicare pay for assisted living

Many people have asked the question; does Medicare pay for assisted living.  The answer to this question differs depending on the type of Medicare coverage you have.

Original Medicare:

Medicare A & B (Original Medicare) does not cover the costs of assisted living.  Because assisted living is not considered medically necessary, it is not covered by either Part A or Part B.  Although, Medicare will provide coverage for approved short-term stays in skilled nursing facilities after inpatient hospital stays. Once the patient has reached 20 days in skilled nursing, there is a $200 a day coinsurance charge.  After 100 days, the beneficiary is responsible for 100% of the cost.

Original Medicare does cover some home health care services as well as hospice care.  Although Original Medicare does not cover assisted living, it does cover all approved medically necessary services under Parts A and B.  This includes hospital stays, medical procedures, screenings and visits to the doctor.

Medicare supplement plans:

Medicare supplement plans are used with Original Medicare. In general, they help cover the deductibles, co-pays and co-insurance that remain after Original Medicare pays its portion. It is in place to supplement Original Medicare.  Therefore, it does not cover assisted living or long-term-care.

Medicare Advantage Plans:

Medicare Advantage plans provide the same coverage as Original Medicare, Parts A and B.  MAPD plans are offered through private health insurance companies.  Most of these plans include prescription drug coverage as well as additional benefits.

Medicare Advantage plans do not cover assisted living costs. However, there are some plans that cover specific services that are similar to assisted living facilities.  These services may include providing coverage for assistance with the activities of daily living, such as transportation to doctors’ appointments and even meal delivery.

Assisted living coverage for dementia patients:

People who have dementia, are eligible for help from Medicare to pay for hospital stays, home health care, skilled nursing home care, hospice care, cognitive assessments and necessary medications. Some eligible patients with Alzheimer’s and dementia may receive payment assistance for care planning. Original Medicare does not provide payment for dementia care however, both Medigap and Medicaid may provide help paying for it.

Ways to pay for assisted living:

The cost of assisted living varies greatly depending on where you live and what the facility provides as well as what each individual requires in terms of care.

1.  One of the best ways to pay for assisted living is through a long-term care policy.  Unfortunately, by the time most people think about it, they are older may not be easily affordable for most individuals. If you are fortunate enough to purchase it while you are young enough that the prices are reasonable, there are many options to choose from.  Look carefully at all the rules and conditions before choosing a policy.
2.  Some people have the foresight to put a large sum aside for such instances.  You may have access to funds from savings, pensions of other sources.
3. Many states provide Medicaid waiver programs that can help pay for medication management, on site therapy or support services in a residential setting.  Medicaid does not pay for the cost of room and board.
4. Eligible veterans may receive assisted living benefits through their local VA.  This benefit may also be available to veterans through some approved non-VA facilities.
5. One more option is through funds obtained through a reverse mortgage.  Unfortunately, if you stay in an assisted living facility for over a year and your home is vacant, the reverse mortgage has to be paid back, this is often done by selling your home.  It is best to speak with a qualified financial counselor before taking this step.

We receive a lot of questions about original Medicare, Medicare Supplement, Medicare Advantage and Medicare part D plans.  A Q and A of the more common questions has been provided below.

Question:  When does my original Medicare A and B plan start?

Answer: Generally, Medicare A and B starts the first of the month you turn 65.  It never starts on the day you turn 65 unless your birth day happens to be on the 1st.  Example:  Bob is 65 on July 18th 2013.  His Medicare A and B will start on July 1, 2013

Question:  Do I need to sign up for Medicare A and B

Answer:  If you are currently taking Social Security payments, you will automatically be enrolled in Medicare A and B.  If you are not taking Social Security payments, you need to call the social security office and sign up for part B of Medicare or enroll online.

Question: How will I be billed for Medicare?

Answer: If you have elected Social Security payments, the part B premium will be taken out of your check automatically.  If you have not elected Social Security, you will be billed quarterly.

Question: How much is Medicare A and B?

Answer:  Part A cost nothing if you or a spouse worked at least 40 quarters (10 years) and contributed toward payroll taxes.  Part B cost $104 per person (will go up in 2014) and increases for those earning higher incomes.

Question: Do I have to enroll in Part B?

Answer: No, you do not need to enroll in part B of Medicare but you will pay a 10% penalty for every year you are eligible and do not enroll.  The exception to this is if you are actively working  and receiving health benefits through your employer.

Question: Do I need part B if my employer gives me retiree benefits?

Answer:  Its a trick question.  If you are retired and getting retiree benefits, you do not have to enroll in part B BUT, you will still have a penalty if you need to enroll in part B down the road. (for example: The employer drops your retiree coverage)  The only valid waiver to the penalty is if you are getting benefits and are actively working.

Question: Does Medicare A and B give me drug coverage?

Answer:  No, Medicare A and B is for medical only.  Drug coverage needs to be purchased through a Part D plan offered by a private insurance company.

Question: What levels of coverage do Medicare A and B provide?

Answer: Generally speaking, Medicare Part A provides hospital coverage and Medicare Part B provides coverage for physicians, testing and other outpatient care.  For a full summary click the link MEDICARE A AND B BENEFITS

Question: How do people cover the things that Original Medicare does not cover?

Answer: They can purchase a Medicare Supplement plan (Also called Medigap) and a part D rx plan or they can purchase a Medicare Advantage plan (MAPD plan). Some people stay on A and B only and simply purchase a stand along Rx plan. (More often they take a supplement or MAPD plan however)

Review our MEDICARE FOR DUMMIES blog for additional information