Janie Slaven: TONI SAYS: Will a Medicare Advantage plan with prescription drugs prevent the "extra" Part D premium?

Janie Slaven, The Times-Tribune, Corbin, Ky.
·3 min read
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Aug. 31—Hello Toni:

I am turning 65 in October, self-employed and my income is over $250,000. Recently I received a letter from the Social Security Administration (SSA) telling me that my monthly Medicare Part B premium of $170.10 would be doubled to $340.20 per month due to 2020 reported income. That was no surprise, but Social Security also said that the monthly adjustment for prescription drug coverage would be an additional $51.70. What is this all about?

I am in excellent health and take NO prescriptions. What happens if I do not apply for a Medicare prescription drug plan? Do I still have to pay the "extra" $51.70?

What if a person goes the Medicare Advantage route instead of Original Medicare and a Medicare supplement? Do they get to avoid the additional $340.20 per month for Part B and the $51.70 per month extra premium for a Medicare Part D prescription drug plan?

—Mike from Oklahoma City, Okla.

Mike:

Sorry, Mike, but you cannot avoid the additional IRMAA (income related monthly adjusted amount) premiums if your income is above a certain limit no matter if you are enrolled in Original Medicare and a Medicare Supplement or a Medicare Advantage plan with prescription drug. It is going to happen anyway!

Social Security bases your income on both you and your spouse (if you are married), whether your spouse is Medicare age or not. The MAGI (modified adjusted gross income) amount that is reported on your yearly income taxes is what triggers the IRMAA increase.

The bottom line is if your income is over these amounts, and you have your Medicare prescription drug plan from either a Medicare Advantage with Prescription Drug Plan (Part C) or Stand-alone Medicare Prescription Drug plan (Part D), you will pay the additional IRMAA premium, whether you are deducting your premiums from your Social Security check or paying direct to Social Security (because you have not started receiving your Social Security check).

If you are not enrolled in a Medicare Part D prescription drug plan, whether stand alone or with a Medicare Advantage plan, you will not receive the addition Part D IRMAA (income related monthly adjusted amount) premium. It is not a wise decision, however, not to enroll in a Medicare Part D plan simply because you are not taking prescriptions at the time you enroll in Medicare.

Remember, if you are not enrolled in a Medicare Part D prescription drug plan at the right time, not only will you not have prescription drug coverage, but you will also receive a Part D late enrollment penalty if you sign up later.

That's why at the Toni Says office, we advise everyone to enroll in a Part D prescription drug plan whether you are taking no prescriptions or a lot of prescriptions. No one wants an additional penalty.

Enrolling in a Medicare Advantage plan instead of Original Medicare with a Medicare Supplement/Medigap and a Medicare Part D plan does not keep Medicare or Social Security from charging the additional IRMAA premium for both Medicare Parts B and D. The IRMAA Medicare rule regarding the Medicare Part D additional IRMAA premiums went into effect on January 1, 2011.

Because the yearly Medicare and You Handbook is generally mailed out before October 1, the costs and premiums for Medicare for that specific year are not included. You should look for annual Medicare costs and premiums to be released around November 10.

Toni King is an author and columnist on Medicare and health insurance issues. She spent more than 27 years as a top sales leader in the fields. For answers to Medicare questions, email: info@tonisays.com or call 832-519-8664.