The Medicare Income Related Monthly Adjustment Amount is billed to Medicare recipients with high incomes. The charge is in addition to the monthly Medicare premium. Unlike the Medicare premium, the IRMAA is billed by and paid directly to the Centers for Medicare and Medicaid Services. IRMAA fluctuates based on changes in the beneficiaries modified adjusted gross income. Failure to pay the IRMAA may result in disenrollment from Medicare.
As of 2015, the IRMAA for individuals who are married filing separately ranges from $272.70 a month for Part B coverage and from $51.30 to $70.80 for prescription coverage. All others pay between $146.90 and $335.70 a month for Part B coverage and between $12.30 and $70.80 a month for prescription drug coverage.
An IRMAA Determination letter is sent to Medicare recipients who receive Medicare Part B, Part D or both, when the Social Security Administration determines that the recipient's income exceeds certain limits. The income limits vary based on tax filing status. The IRMAA may apply to individuals filing as single, head of household, widowed, and those who are married fling separately, if the person's income exceeds $85,000 a year. Persons who are married filing jointly may qualify for the IRMAA if the couple's combined income exceeds $170,000 a year.