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Changes to IRMAA for 2019

For 2019, there is a change to the Income-Related Monthly Adjustment Amounts (IRMAA) for Medicare. The change is to add another level of adjustment to IRMAA for 2019.

In the past, there were five levels of IRMAA. For 2019, there is a new level added to the top end of the IRMAA adjustments.

IRMAA for 2019

The previous levels remain the same – the first level being the standard premium for Medicare Part B. For 2019, this is $135.50, up $1.50 from 2018. This represents 25% of the actual cost of Medicare Part B. Single people with Modified Adjusted Gross Income (MAGI) up to $85,000 are eligible for this premium amount. Married folks with MAGI up to $170,000 also pay this amount.

The second level, for singles with MAGI between $85,001 and $107,000 (married between $170,001 to $214,000), have their Medicare Part B premium adjusted upward to pay a total of 35% of the true cost. This amounts to a premium of $189.60 for 2019.

When MAGI for singles is between $107,001 and $133,500 ($214,001 to $267,000 for married), the third level premium for Medicare Part B is adjusted to $267.90, which is 50% of the cost of Part B. Between the MAGI amounts of $133,501 and $160,000 for singles ($267,001 to $320,000 if married), the premium for the fourth level jumps to $352.20, which is 65% of Part B’s cost.

The fifth level pays 80% of the cost of Medicare Part B. This applies to singles with MAGI between $160,001 and $500,000 (between $320,001 and $750,000 for marrieds). The premium at this level is $433.40.

The sixth level of IRMAA for 2019 applies to singles with MAGI above $500,000, and married folks with MAGI above $750,000. This level of IRMAA’s premium is $460.50, which is 85% of the true cost of Medicare Part B.

There is also a new level of Medicare Part D premium adjustment for 2019 (we’ll cover in another article).

Also New for 2019: Marriage Penalty

It should be noted that the IRMAA-adjusted premium for Medicare Part B applies to both members of a married couple, and is based on the jointly-filed tax return’s MAGI. 

Also with the new level of IRMAA for 2019, for the first time a marriage penalty is introduced. Previously the IRMAA adjustment MAGI levels for married folks were simply double the single MAGI levels. As detailed above, starting in 2019, the fifth level for married folks is capped at $750,000, which is only 1½ times the upper level for single people. This level then becomes the lower end of the top level of IRMAA for 2019.


  1. Joe says:

    Hi Jim,

    Really enjoy your informative articles. I agree that I do not like the woman with the name IRMAA. Your earlier post indicated that IRMAA was based off income from 2 years prior. What is the rationale for this? While I don’t like the idea at all, It seems unfair to tax us based on what we made 2 years ago when our pre-retirement incomes were high. What gives?

    1. jblankenship says:

      If you’ve retired you should be able to appeal the IRMAA determination due to life change.

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