While Medicare is not based on how much you earn the way Medicaid is, your income can impact the amount you pay for premiums. If Medicare has labeled you a high-income beneficiary, your premiums might be higher due to the Income-Related Monthly Adjustment Amount, or IRMAA. IRMAA only impacts your premiums for Medicare Part B and Medicare Part D.

The majority of people on Medicare will pay $174.40 per month for their Medicare Part B premium in 2024. This is around 25% of the total premium cost, with Medicare paying the remainder. However, higher income beneficiaries pay a larger portion of this premium depending on their Modified Adjusted Gross Income (MAGI). This can be 35, 50, 65, or 80 percent depending on your income. Higher income refers to anyone whose MAGI is more than $103,000 per year (filing single or married filing separately) or $206,000 per year (married filing jointly).

Since there is no standard Part D monthly premium (as plans are sold by private insurers), the IRMAA surcharge is based on the national base beneficiary premium. In 2024, this is $34.70.

Even if you pay your Medicare Part D premium another way, the Part D IRMAA surcharge comes out of your social security benefits. If you do not collect social security benefits, then the bill comes from a relevant federal agency, such as the Centers for Medicare & Medicaid Services (CMS).

The table below shows the IRMAA surcharge for different income levels.