Before you turn 65, you'll want to become familiar with Medicare's rules and features. And if you're a high earner, you'll want to be especially aware of the Medicare premium surcharge — because, over time, it can add up to some significant dollars.

 

The premium surcharge — known as the income related monthly adjustment amount, or IRMAA — is assessed on premiums for Medicare Parts B and D, and generally is based on an individual's modified adjusted gross income (MAGI) of two years ago. So, the IRMAA for 2023 would be based on one's MAGI from 2021.

 

For someone who's married and files taxes jointly, and whose MAGI for 2021 was $194,000 or less, the Part B premium for 2023 will be $164.90 per month, and the Part D premium will be whatever amount is charged by their Medicare plan. But if their 2021 MAGI was between $194,000 and $246,000, they'll pay $230.80 (a surcharge of $65.90) for Part B and an additional $12.20 for Part D. And the IRMAA rises at different income levels, reaching a maximum of $560.50 (a surcharge of $395.60) for Part B and an additional $76.40 for Part D for a MAGI of $750,000 or more.

 

If you're unprepared for the IRMAA, it can be an unpleasant surprise. So, if you've still got a few years until you enroll in Medicare, you may want to look for ways to control your MAGI and possibly limit the surcharge.