Medicare Premiums: Rules For Higher-Income Beneficiaries 
The law requires an adjustment to your monthly Medicare Part B medical insurance and Medicare prescription drug coverage premiums. This affects less than five percent of people with Medicare. Most people don t pay higher premiums. 

If You Have a Higher Income 
If you have higher income , you ll pay an additional premium amount for Medicare Part B and Medicare prescription drug coverage. We call the additional amount the income - related monthly adjustment amount. Here s how it works : Part B helps pay for your doctors services and outpatient care. It also covers other medical services, such as physical and occupational therapy, and some home health care. For most beneficiaries , the government pays a substantial portion about 75 percent of the Part B premium , and the beneficiary pays the remaining 25 percent. If we determine you re a higher - income beneficiary , you ll pay a larger percentage of the total cost of Part B based on the income you normally report to the Internal Revenue Service IRS. You ll pay monthly Part B premiums equal to 35 , 50 , 65 , 80, or 85 percent of the total cost, depending on what you report to the IRS. Medicare prescription drug coverage helps pay for your prescription drugs. For most beneficiaries , the government pays a major portion of the total costs for this coverage , and the beneficiary pays the rest. Prescription drug plan costs vary depending on the plan, and whether you get the Extra Help, also known as the subsidy, with your portion of the Medicare prescription drug coverage costs. If you re a higher - income beneficiary with Medicare prescription drug coverage , you ll pay monthly premiums plus an additional amount, which is based on what you report to the IRS. Because individual plan premiums vary , the law specifies that the amount is determined using a base premium. We tie the additional amount you pay to the base beneficiary premium, not your own premium amount

user: I have so many questions about medicare premiums, I don't even know where to begin.

assistant: No problem. First you should know that the law requires an adjustment to your monthly Medicare Part B medical insurance and Medicare prescription drug coverage premiums. This affects less than five percent of people with Medicare. Most people don t pay higher premiums.

user: Can you tell me how you determine my 2020 income-related monthly adjustment amounts when it comes to tax return?

assistant: Of course. We use your most recent federal tax return the IRS provides to us. Generally, this information is from a tax return filed in 2019 for tax year 2018. Sometimes, the IRS only provides information from a return filed in 2018 for tax year 2017.

user: I see. What if my income has increased?

assistant: Do you have a higher income?

user: No? No, just forget it. I didn't mention anything like that.

user: Well, if I WAS a higher income beneficiary with Medicare prescription drug coverage, what would that entail?

assistant: You'd pay monthly premiums plus an additional amount, which is based on what you report to the IRS. Because individual plan premiums vary, the law specifies that the amount is determined using a base premium.