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Medicare Part B Premiums: New Rules For Beneficiaries With Higher Incomes 2009SSA Publication No. 05-10161, December 2008 ICN 468800 [View .pdf] (En EspaƱol) |
The Medicare Modernization Act of 2003 changed how Medicare Part B premiums are calculated for some higher income beneficiaries. The majority of Medicare beneficiaries are not affected. Part B (medical insurance) helps pay for doctors’ services and outpatient care. It also covers other medical services, such as physical and occupational therapy, and some home health care. For most beneficiaries, the government pays a substantial portion—75 percent—of the Part B standard premium and the beneficiary pays the remaining 25 percent. Since 2007, higher income beneficiaries have been paying a larger percentage of their Part B premium based on income they reported to the Internal Revenue Service (IRS). In 2009, higher income beneficiaries will pay a monthly premium equal to 35, 50, 65 or 80 percent of the total cost, depending on what they reported to the IRS. However, the law affects less than 5 percent of Medicare beneficiaries, so most people will continue to pay the standard premium without an income-related adjustment. |
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How will I know if I must pay more?To determine if you will pay a higher Part B premium, the IRS will send Social Security information from your most recent tax return. We will use a sliding scale to make adjustments to premiums. The sliding scale will be based on your modified adjusted gross income (MAGI). Your MAGI is a combination of your adjusted gross (taxable) income and tax exempt interest income. After getting the IRS data, if we determine you will need to pay a larger percent of the premium, we will send you a letter explaining how we made this determination and what your new premium will be. However, it is important to remember that if your income does not exceed the limits described above, this law does not apply to you. |
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Which tax return will you use?To determine your 2009 Part B premium, we will use the most recent tax return information provided by IRS. Generally, this information is from a tax return filed in 2008 (for tax year 2007). Sometimes, IRS can only provide information from a return filed in 2007 (for tax year 2006). If we use tax year 2006 data and you filed a return for tax year 2007 or did not need to file a tax return for tax year 2007, call us or visit any office. We will update our records. If you amended your tax return and it changes the income we count, let us know. Send Social Security a copy of the amended tax return that you filed and your acknowledgment receipt from IRS. We will update our records with the information you provide, and correct your Part B premiums back to the earliest time in the year you had Part B. |
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What if my income has gone down?If your income has gone down due to any of the following circumstances and the change will make a difference in the income level we consider, contact us to explain that you have new information and may need a new decision about your Medicare Part B premium:
If any of these events happen, you will need to show us evidence of the event and tell us how it has reduced your income. Evidence could be a death certificate, a letter from your employer about your retirement, or something similar. If you filed a federal income tax return for the year in question, you will need to show us your signed copy of the return. |
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What if I disagree?If you disagree with the decision regarding your Medicare Part B premium amount, you have the right to appeal. You may request an appeal in writing by completing "Request for Reconsideration" (Form SSA-561-U2) or you may contact your local Social Security office to file your appeal. You can find the appeal form online at www.socialsecurity.gov/online or request a copy through our toll-free number, 1-800-772-1213 (TTY 1-800-325-0778). You do not need to file an appeal if you are requesting a new decision because of an event listed previously that made your income go down or if you have shown us the information we used is wrong. |
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Contacting Social SecurityFor more information, visit our website at www.socialsecurity.gov/mediinfo.htm or call toll-free, 1-800-772-1213 (TTY 1-800-325-0778). To learn more about Medicare Part B coverage, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227;TTY 1-877-486-2048). |
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Monthly Part B Premiums for 2009
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If you are married and lived with your spouse at some time during the taxable year, but filed a separate tax return, the following chart will apply: |
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Last reviewed or modified Tuesday Nov 04, 2008 |