How does income impact Medicare costs?

Published by Medicare Made Clear®


When you become eligible for Medicare and look at how much to budget for your annual health care costs, you’ll need to also factor in your tax-reported income. Medicare has set income limits for people filing individual tax returns, joint tax returns and individuals who are married or living with their spouse at any time during the year and file separate tax returns. These limits are then used to determine adjusted costs for Medicare Part B and Part D premiums.

Depending on how much you make, you may have to pay an income-related monthly adjustment amount (IRMAA) for Part B and Part D. This amount and the income limits Medicare set can both change every year.

In 2024, people with tax-reported incomes over $103,000 (single) and $206,000 (joint) must pay an income-related monthly adjustment amount for Medicare Part B and Part D premiums.

Below are the set income limits and extra monthly costs you could pay for Medicare Part B and Part D based on your tax-reported income.

How much will your Medicare Part B premium be?

The tables below show Part B premiums for 2024 by filing status and income level. The IRMAA is based on your reported adjusted gross income from two years ago. For 2023, your Part B premium may be as low as $174.70 or as high as $594.00.

If you file an Individual Tax Return or Joint Tax Return

If you file an Individual Tax Return or Joint Tax Return
Filing Individual Tax Returns Filing Joint Tax Returns Total monthly Part B premium

$103,000
or less

$206,000
or less

$174.70

Over $103,000
& Up to
$129,000

Over $206,000
& Up to
$258,000

$244.60

Over $129,000
& Up to
$161,000

Over $258,000
& Up to
$322,000

$349.40

Over $161,000
& Up to
$193,000

Over $322,000
& Up to
$386,000

$454.20

Over $193,000
& Less than
$500,000

Over $386,000
& Less than
$750,000

$559.00

$500,000
or more

$750,000
or more

$594.00

If you’re married and file separate tax returns

If you’re married and file separate tax returns
Married, filing separate tax returns Total monthly Part B premium

$103,000 or less

$174.70

Over $103,000 & Less than $397,000

$559.00

$397,000 or more

$594.00

How much extra could you pay for Medicare Part D?

With Part D, the extra amount you pay is determined by Medicare based on your tax-reported income, but your total costs will depend on the Part D plan you have. Part D plans are only provided by private insurance companies, so premium amounts will vary.

The table below shows the monthly income amount that will be added to your specific Part D plan premium for 2024 based on filing status and income level.

How much extra could you pay for Medicare Part D?
File Individual Tax Return File Joint Tax Return Married & Separate Tax Return Your Part D monthly premium (2024)

$103,000
or less

$206,000
or less

$103,000
or less

Your plan’s premium

Over $103,000
& Up to
$129,000

Over $206,000 & Up to $258,000

not applicable

$12.90 + your plan premium

Over $129,000 & Up to $161,000

Over $258,000 & Up to $322,000

not applicable

$33.30 + your plan premium

Over $161,000 & Up to $193,000

Over $322,000 & Up to $386,000

not applicable

$53.80 + your plan premium

Over $193,000 & Less than $500,000

Over $386,000 & Less than $750,000

Over $103,000
& Less than
$397,000

$74.20 + your plan premium

$500,000
or more

$750,000
or more

$397,000
& above

$81.00 + your plan premium

Paying for Medicare premiums tips: Your HSA and employer health plan

From the above, you can see you may face higher costs for Medicare than you originally thought. That’s why you should consider two things – a health savings account plan (HSA) and if you have employer health coverage.

If you have an HSA and must get Medicare at age 65, the good news is that you can use your HSA funds to pay for Medicare costs including Part B and Part D premiums. Your HSA also can help with other costs, and you can learn more about how Medicare and HSAs work here.

If you have an employer health plan that’s considered creditable coverage – either yours or your spouse’s – you may be able to delay enrolling Medicare. This is a key consideration if your employer health plan costs less than what you may pay with Medicare. See if you can delay Medicare enrollment here.

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