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Mark Miller: Remaking Retirement

Understanding Medicare Surcharges

Wealthy enrollees pay more for premiums--how can you avoid it?

Medicare benefits are the same for everyone in the program--but the wealthy pay more for them.

Since 2007, high-income enrollees have been paying surcharges on their premiums for Part B (outpatient services) and Part D (prescription drugs). Relatively few people on Medicare pay the so-called income-related monthly adjustment amount, or IRMAA--but the surcharges can be steep. The brackets that determine who pays IRMAA will be tweaked in 2020 in a way that will get some people off the hook, at least temporarily; that makes this a good time to consider how IRMAA is structured, how it is changing, and how you might be able to avoid paying it.