In January of 2011, the Affordable Care Act established an income related monthly adjustment amount (IRMAA) under the Part D program (prescription portion of Medicare) which is known as the Part D-IRMAA. The Part D-IRMAA is an amount added to the Part D monthly premium for individuals whose modified adjusted gross income (MAGI) exceeds certain threshold amounts. The Social Security Administration has published a document which explains the rules for higher-income beneficiaries. Note: Members who are currently paying a higher premium than the minimum for their Part B coverage are the same members who will be affected by this Part D adjustment amount.
Members who are affected by this ‘IRMAA’ provision will be billed by the Social Security Administration/Medicare for this additional premium charge. If billed, the affected member must pay this amount directly to that entity. If the member does not pay this Part D-IRMAA amount, the State-sponsored Medicare Advantage with Prescription Drug plan (MAPD) will be terminated by Federal CMS and the member will lose his/her group health, vision and prescription insurance benefits.