We use the most recent federal tax return the IRS provides to us. How Social Security Determines You Have a Higher Premium This agency may be the Centers for Medicare & Medicaid Services or the Railroad Retirement Board. If the amount is greater than your monthly payment from Social Security, or you don’t get monthly payments, you’ll get a separate bill from another federal agency. If you’re a higher-income beneficiary, we deduct this amount from your monthly Social Security payments regardless of how you usually pay your monthly prescription plan premiums. We tie the additional amount you pay to the base beneficiary premium, not your own premium amount. Because individual plan premiums vary, the law specifies that the amount is determined using a base premium. This amount is based on what you report to the IRS. If you’re a higher-income beneficiary with Medicare prescription drug coverage, you’ll pay monthly premiums plus an additional amount. 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. For most beneficiaries, the government pays a major portion of the total costs for this coverage, and the beneficiary pays the rest. Medicare prescription drug coverage helps pay for your prescription drugs. You’ll pay monthly Part B premiums equal to 35%, 50%, 65%, 80%, or 85% of the total cost, depending on what you report to the IRS. 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). For most beneficiaries, the government pays a substantial portion - about 75% - of the Part B premium, and the beneficiary pays the remaining 25%. It also covers other medical services, such as physical and occupational therapy, and some home health care. Part B helps pay for your doctors’ services and outpatient care. We call the additional amount the “income-related monthly adjustment amount.” Here’s how it works: If you have higher income, you’ll pay an additional premium amount for Medicare Part B and Medicare prescription drug coverage. The law requires an adjustment to your monthly Medicare Part B (medical insurance) and Medicare prescription drug coverage premiums.
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