20 C.F.R. § 418.1120

Current through September 30, 2024

Section 418.1120 - How do we determine your income-related monthly adjustment amount?

(a) We will determine your income-related monthly adjustment amount by using your tax filing status and modified adjusted gross income.

(b)Tables of applicable percentage. The tables in paragraphs (b)(1) through (b)(3) of this section contain the modified adjusted gross income ranges for calendar years 2011 through and including 2017, 2018, and beginning in 2019 in the column on the left in each table. The middle column in each table shows the percentage of the unsubsidized Medicare Part B premium that will be paid by individuals with modified adjusted gross income that falls within each of the ranges. The column on the right in each table shows the percentage of the Medicare Part B premium that will be subsidized by contributions from the Federal Government. We use your tax filing status and your modified adjusted gross income for the tax year to determine which income-related monthly adjustment amount to apply to you. The dollar amount of income-related monthly adjustment for each range will be set annually for each year after 2019 as described in paragraph (c) of this section. The modified adjusted gross income ranges will be adjusted annually after 2019 as described in § 418.1115(e) .

(1)General tables of applicable percentages. If, for the tax year, we use your filing status for your Federal income taxes for the tax year is single; head of household; qualifying widow(er) with dependent child; or married filing separately and you lived apart from your spouse for the entire tax year, we will use the general tables of applicable percentages. When your modified adjusted gross income for the year we use is in the range listed in the left column in the following tables, then the Federal Government's Part B premium subsidy of 75 percent is reduced to the percentage listed in the right column. You will pay an amount based on the percentage listed in the center column.

Table 1 to paragraph (b)(1): Modified adjusted gross income effective in 2011-2017	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000 but less than or equal to $107,000	35	65
Greater than $107,000 but less than or equal to $160,000	50	50
Greater than $160,000 but less than or equal to $214,000	65	35
Greater than $214,000	80	20

Table 2 to paragraph (b)(1): Modified adjusted gross income effective in 2018	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000 but less than or equal to $107,000	35	65
Greater than $107,000 but less than or equal to $133,500	50	50
Greater than $133,500 less than or equal to $160,000	65	35
Greater than $160,000	80	20

Table 3 to paragraph (b)(1): Modified adjusted gross income effective beginning in 2019	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000 but less than or equal to $107,000	35	65
Greater than $107,000 but less than or equal to $133,500	50	50
Greater than $133,500 but less than or equal to $160,000	65	35
Greater than $160,000 but less than $500,000	80	20
Greater than or equal to $500,000	85	15

(2)Tables of applicable percentages for joint returns. If, for the tax year, we use your Federal tax filing status is married filing jointly for the tax year and your modified adjusted gross income for that tax year is in the range listed in the left column in the following tables, then the Federal Government's Part B premium subsidy of 75 percent is reduced to the percentage listed in the right column. You will pay an amount based on the percentage listed in the center column.

Table 1 to paragraph (b)(2): Modified adjusted gross income effective in 2011-2017	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $170,000 but less than or equal to $214,000	35	65
Greater than $214,000 but less than or equal to $320,000	50	50
Greater than $320,000 but less than or equal to $428,000	65	35
Greater than $428,000	80	20

Table 2 to paragraph (b)(2): Modified adjusted gross income effective in 2018	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $170,000 but less than or equal to $214,000	35	65
Greater than $214,000 but less than or equal to $267,000	50	50
Greater than $267,000 but less than or equal to $320,000	65	35
Greater than $320,000	80	20

Table 3 to paragraph (b)(2): Modified adjusted gross income effective beginning in 2019	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $170,000 but less than or equal to $214,000	35	65
Greater than $214,000 but less than or equal to $267,000	50	50
Greater than $267,000 but less than or equal to $320,000	65	35
Greater than $320,000 but less than $750,000	80	20
Greater than or equal to $750,000	85	15

(3)Tables of applicable percentages for married individuals filing separate returns. If, for the tax year, we use your Federal tax filing status is married filing separately, you lived with your spouse at some time during that tax year, and your modified adjusted gross income is in the range listed in the left column in the following tables, then the Federal Government's Part B premium subsidy of 75 percent is reduced to the percentage listed in the right column. You will pay an amount based on the percentage listed in the center column.

Table 1 to paragraph (b)(3): Modified adjusted gross income effective in 2011-2017	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000 but less than or equal to $129,000	65	35
Greater than $129,000	80	20

Table 2 to paragraph (b)(3): Modified adjusted gross income effective in 2018	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000	80	20

Table 3 to paragraph (b)(3): Modified adjusted gross income effective beginning in 2019	Beneficiary percentage (percent)	Federal premium subsidy (percent)
Greater than $85,000 but less than $415,000	80	20
Greater than or equal to $415,000	85	15

(c) For each year after 2019, CMS will annually publish in the FEDERAL REGISTER the dollar amounts for the income-related monthly adjustment amount described in paragraph (b) of this section.

20 C.F.R. §418.1120

As amended at 83 FR 55628, 11/7/2018