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SSA/Medicare IRMAA With Medicare Advantage MAPD

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Medicare Advantage MAPD plans include Part A, B, D benefits and may include some additional benefits [useless EyeMed from Luxoticca (owner of Lenscrafters, Pearl)], etc.

People must continue to maintain Part A [free after sufficient work credits (own or spouse's)] and Part B [basic premium + late-penalty + IRMAA] - the required amounts are deducted from Social Security payments, or people are billed by SSA. The MAPD may have a premium of its own.

My question is about IRMAA for Part D. Even when one doesn't pay specifically for Part D [because it is already covered by MAPD], can SSA charge IRMAA?

SSA is saying we have to pay Part D IRMAA. I am thinking that extra on $0 premium is still $0. What is wrong with that argument? Before I appeal to SSA, I thought I run this here as there are several posters with IRMAA. Our huge MAPD Guide/Handbook is brief and not very clear on this.

Under the original Medicare [Part A, B] as primary with employer retiree coverage as secondary [which included creditable prescription coverage], this wasn't an issue. But our coverage is changing to MAPD on 1/1/20.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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@PatMorgan , @GLI2019 , thanks.

On further search, I found the link below [and some others] that also confirm that standalone Part D and MAPD [that include Part D coverage] will have IRMAA for Part D regardless of the payment for MAPD plan.

https://q1medicare.com/q1group/MedicareAdvantagePartDQA/FAQ.php?faq=Can-I-be-assessed-an-Income-Rela...

"Can I be assessed an Income-Related Monthly Adjustment Amount (IRMAA) for Medicare Part D if I am enrolled in a Medicare Advantage (MAPD) plan?

 
Yes.   If you are a Medicare beneficiary and your annual income (MAGI) exceeds certain limits - and you are enrolled in a Medicare Advantage plan (HMO, PPO, or PFFS) that includes prescription drug coverage (MAPD), then your MAPD actually includes Medicare Part D drug coverage (along with Medicare Part A and Medicare Part B coverage) - and you can be charged an Income-Related Monthly Adjustment Amount (IRMAA) for both your Medicare Part D and Medicare Part B coverage.

In short, Medicare Part D IRMAA is assessed to anyone getting Part D coverage from a stand-alone Medicare Part D plan (PDP) -- Medicare Advantage plan that includes drug coverage (MAPD) -- or a Medicare Cost plan - even if this coverage is paid for by your employer, union, or retiree health plan.

Will I pay Part D IRMAA if my Medicare Advantage plan does not have drug coverage?

No.  If you are enrolled in a Medicare Advantage plan that does not include prescription drug coverage (MA) and you do not have any other Medicare Part D prescription drug coverage, then you will not be charged Medicare Part D IRMAA -- but you will still pay Medicare Part B IRMAA.

What if you are enrolled in an MAPD with a $0 premium?

Even if you are enrolled in a Medicare Advantage plan (MAPD) with a $0 premium - or a Medicare Advantage plan that returns or rebated a portion of your Part B premium, when your income exceeds the IRMAA limits (such as $87,000 for an individual in 2020), you will need to pay Medicare Part D IRMAA (and Medicare Part B IRMAA)....."
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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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Yogi,

My university employer made noises about making a similar change and then backed off (don't know why).

I assumed--can't say why--that IRMAA would apply to Part D.

Edit: I now see why Part B & D were linked in my mind with respect to IRMAA:

https://www.ehealthinsurance.com/medicare/part-d-all/what-are-medicare-part-d-irmaa-and-part-b-irmaa

Bob 

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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As clarification, we pay Part B premium and Part B IRMAA.

We don't pay Part D premium, so the SSA demand for Part D IRMAA surprised us.

Notice is from SSA, not the employer. 

It could be that only the basic Part D premium is built into MAPD monthly payments and we may have to pay IRMAA. Our MAPD Guide/Handbook says to pay whatever SSA wants, otherwise the coverage can be dropped.

I just wanted to check with posters here. If they are subject to IRMAA, and have MAPD, do they pay IRMAA on Part B only, or also on Part D?

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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Based on personal experience, IRMAAs apply to Medicare Part B and Part D even if the Medicare Advantage plan being used has a premium of $0.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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@PatMorgan , @GLI2019 , thanks.

On further search, I found the link below [and some others] that also confirm that standalone Part D and MAPD [that include Part D coverage] will have IRMAA for Part D regardless of the payment for MAPD plan.

https://q1medicare.com/q1group/MedicareAdvantagePartDQA/FAQ.php?faq=Can-I-be-assessed-an-Income-Rela...

"Can I be assessed an Income-Related Monthly Adjustment Amount (IRMAA) for Medicare Part D if I am enrolled in a Medicare Advantage (MAPD) plan?

 
Yes.   If you are a Medicare beneficiary and your annual income (MAGI) exceeds certain limits - and you are enrolled in a Medicare Advantage plan (HMO, PPO, or PFFS) that includes prescription drug coverage (MAPD), then your MAPD actually includes Medicare Part D drug coverage (along with Medicare Part A and Medicare Part B coverage) - and you can be charged an Income-Related Monthly Adjustment Amount (IRMAA) for both your Medicare Part D and Medicare Part B coverage.

In short, Medicare Part D IRMAA is assessed to anyone getting Part D coverage from a stand-alone Medicare Part D plan (PDP) -- Medicare Advantage plan that includes drug coverage (MAPD) -- or a Medicare Cost plan - even if this coverage is paid for by your employer, union, or retiree health plan.

Will I pay Part D IRMAA if my Medicare Advantage plan does not have drug coverage?

No.  If you are enrolled in a Medicare Advantage plan that does not include prescription drug coverage (MA) and you do not have any other Medicare Part D prescription drug coverage, then you will not be charged Medicare Part D IRMAA -- but you will still pay Medicare Part B IRMAA.

What if you are enrolled in an MAPD with a $0 premium?

Even if you are enrolled in a Medicare Advantage plan (MAPD) with a $0 premium - or a Medicare Advantage plan that returns or rebated a portion of your Part B premium, when your income exceeds the IRMAA limits (such as $87,000 for an individual in 2020), you will need to pay Medicare Part D IRMAA (and Medicare Part B IRMAA)....."
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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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Yes, that’s been our experience. We pay both a Part B and a Part D IRMAA. I don’t think it’s tied to your Medicare Advantage premium costs, but strictly based on MAGI. 

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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I believe that IRMMA, no matter what it is called by the politicians, is nothing more than a tax that is based on your being relatively successful in acquiring some wealth.  It should not be considered an additional premium charge.  It's the same as you paying a school  tax when you have no children being educated in the local schools.  With IRMMA you are paying, because you can, for drug and medical expenses for those who can't, or won't because they have found a way around the system.  It is not a premium because you are not getting any additional benefits for the amount of IRMMA you are paying.  I wonder if that part of the ACA would have been passed if they had honestly referred to IRMMA as a tax.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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This topic is way, way above my pay scale thanks to ROTH although I also have the same MA plan (MAPD plan).

 

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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Clearly from a tax policy perspective, Medicare and Social Security are more progressive than the regular income tax code. (Remember Warren Buffett’s famous quote that he pays less tax than his secretary as a percent of income.) Having seen close relatives face medical crises while poor and old, I appreciate the desperation and panic they faced, through no choice of their own, at their most vulnerable time in life. While I may not particularly like it on about April 15, I understand the policy rationale and support it. 

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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Thanks for bringing this to my attention, as I was unaware that I will pay an additional tax.  This is nothing more than a success tax, a strong incentive NOT to work and NOT to save.  My spouse, who wants to work,  will be paying out nearly 50 percent in income taxes, medicare taxes, social security taxes, IRMMA taxes. Work 5 days a week and get paid for 2 and a half, better to work in the underground economy for CASH under the table than work for nothing.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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  • @myob wrote:

    Thanks for bringing this to my attention, as I was unaware that I will pay an additional tax.  This is nothing more than a success tax, a strong incentive NOT to work and NOT to save.  My spouse, who wants to work,  will be paying out nearly 50 percent in income taxes, medicare taxes, social security taxes, IRMMA taxes. Work 5 days a week and get paid for 2 and a half, better to work in the underground economy for CASH under the table than work for nothing.


 Not exactly. IRMMA is a tax on the 5% of taxpayers who have the highest taxable incomes defined by congress. If your wife is paying 50% in taxes then she is in the top 1 % of taxpayers who have sufficient income to pay all those taxes. Your wife choses to work and make more money than bottom 99% of taxpayers instead of working at a lower paying job and paying less taxes. It was her choice. She can retire and lower her income to be taxed less. 

you will get no sympathy from me because you are in the highest income bracket for which you and your spouse correspondingly pay the highest percentage of taxes, because US tax system is progressive- those with highest incomes pay highest taxes. Been that way since 1913. Your wife can always lower her taxes by reducing her income. No brainer.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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@yogibearbullAs others have commented, IRMAA is based on MAGI.  IRMAA applies to both Part B and Part D of Medicare. It's not tied to your Part C Med Advantage plan or its premium.  If you are subject to IRMAA on part B your are subject to it on Part D and you get bills from Medicare for those.  I already received my Part B bill and am waiting for my Part D bill.  the initial Part D bill usually lags the Part B bill by a few weeks and is a "catch up" bill to bring you current. For example, I received my Jan 2020 Part B bill at the end of Nov 2019 which I paid in December.  I just saw my Feb 2020 posted online and it has the Part B amount + 2 months worth of Part D to get me current.  Future bills should contain one month's worth of Part B and Part D amounts in a single bill.

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Re: SSA/Medicare IRMAA With Medicare Advantage MAPD

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@perrywinkle wrote:

@yogibearbullAs others have commented, IRMAA is based on MAGI.  IRMAA applies to both Part B and Part D of Medicare. It's not tied to your Part C Med Advantage plan or its premium.  If you are subject to IRMAA on part B your are subject to it on Part D and you get bills from Medicare for those.  I already received my Part B bill and am waiting for my Part D bill.  the initial Part D bill usually lags the Part B bill by a few weeks and is a "catch up" bill to bring you current. For example, I received my Jan 2020 Part B bill at the end of Nov 2019 which I paid in December.  I just saw my Feb 2020 posted online and it has the Part B amount + 2 months worth of Part D to get me current.  Future bills should contain one month's worth of Part B and Part D amounts in a single bill.


I thank you and others for the answer to my OP - that IRMAA applies to Parts B and D for MAPD. I was just surprised that the IRMAA surcharge applied to what we weren't paying directly [i.e. Part D premiums].

Purpose wasn't to question IRMAA. My understanding is that at their basic levels, Part B and D are heavily subsidized by the US Government, and those subsidies decrease as incomes go up. Even at their highest premium levels, Medicare premiums may be competitive with what may be available as private health insurance - if available at all.

For strange reasons [not relevant here], my wife's Medicare premiums are deducted from her monthly Social Security payments, so she got a notice on Part D IRMAA, including some catch up, just a couple of days ago. And that got me investigating this matter. I get billed quarterly and my bills up to Nov 2019 didn't have Part D IRMAA. My next bill for Feb 2020 isn't posted yet and I am now sure that it will have Part D IRMAA. 

Anyway, the information provided by posters have saved me from foolishly appealing all this as a mistake by SSA/Medicare.

In a sense, this thread should become inactive now although some comments may continue for a while.

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