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Medicare

IRMAA 

(Income-Related Monthly Adjustment Amount) 

IRMAA (Income-Related Monthly Adjustment Amount) is an additional charge that Medicare enrollees may need to pay for their Medicare Part B (medical insurance) and Part D (prescription drug coverage) if their income is above a certain threshold. This extra amount is based on an individual’s or couple's modified adjusted gross income (MAGI) from two years prior.

In short, IRMAA is an income-adjusted premium for higher-income Medicare beneficiaries to help offset the costs of Medicare. Each year, the income brackets are reassessed, so the amount people pay can change annually based on their income level and any changes in Medicare’s premium structure.

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When to Start Medicare

You can start Medicare when you turn 65, with your first opportunity being the Initial Enrollment Period (IEP), which begins three months before the month you turn 65 and lasts for seven months in total (three months before, the month of, and three months after your birthday month). Here’s a quick guide to when to start:

  1. Turning 65: Most people become eligible for Medicare at 65. If you’re already receiving Social Security benefits at that time, you’ll be automatically enrolled in Medicare Part A and Part B. If not, you’ll need to sign up during your IEP.

  2. Delayed Enrollment (Still Working or Have Coverage): If you or your spouse are still working and have health coverage through an employer, you may choose to delay Medicare Part B enrollment. In this case, you’ll qualify for a Special Enrollment Period (SEP) later on, which lets you sign up without penalty after your employer coverage ends.

  3. Under 65 with Certain Disabilities: If you’re under 65 and have been receiving Social Security Disability Insurance (SSDI) for 24 months or have conditions like End-Stage Renal Disease (ESRD) or ALS, you can qualify for Medicare earlier.

Note on Penalties: Failing to sign up for Medicare Part B or Part D (prescription drug coverage) when you’re first eligible and without other qualifying coverage could result in late enrollment penalties.

Tip: Even if you don’t need additional coverage, it’s often wise to enroll in Medicare Part A at 65, as it’s typically premium-free if you’ve worked 10 years or more.


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