Medicare vs IRMAA vs health care coverage

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ps56k
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Medicare vs IRMAA vs health care coverage

Post by ps56k » Fri Feb 14, 2020 2:34 pm

Just wondering.....
If you look at the Medicare IRMAA surcharge chart, it gets pretty expensive as your MAGI gets higher.
Are you required to take Medicare in retirement ?

Basically - can you chose to NOT take Medicare Part B- NOT pay the Medicare premiums + NOT pay the IRMAA -
If so, what do you do to handle health care coverage ....

SO... No Medicare, No IRMAA, and no implied health coverage from Medicare -
BUT... then - where and how do you get "something" to cover your health care needs ?

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491

neilpilot
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Re: Medicare vs IRMAA vs health care coverage

Post by neilpilot » Fri Feb 14, 2020 2:39 pm

In most cases, if you decide to forgo Part B (and also Part D) and years later change your mind and decide to start coverage, isn't there a "permanent" penalty tacked on to the premium since you failed to start coverage earlier?

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Fri Feb 14, 2020 2:47 pm

There isn't any ACA subsidy available either. Might be able to find insurance off the exchange.

You will also want either Medicare Advantage or a Medicare supplemental.

However, if you have to pay a MAGI, you can afford Medicare. It is still cheap compared to private insurance.

FactualFran
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Re: Medicare vs IRMAA vs health care coverage

Post by FactualFran » Fri Feb 14, 2020 3:57 pm

prd1982 wrote:
Fri Feb 14, 2020 2:47 pm
However, if you have to pay a MAGI, you can afford Medicare. It is still cheap compared to private insurance.
With the highest additional amount, the Medicare Part B premium covers 85% of what the government pays in benefits. The standard premium covers 25%.

adamthesmythe
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Re: Medicare vs IRMAA vs health care coverage

Post by adamthesmythe » Fri Feb 14, 2020 4:18 pm

neilpilot wrote:
Fri Feb 14, 2020 2:39 pm
In most cases, if you decide to forgo Part B (and also Part D) and years later change your mind and decide to start coverage, isn't there a "permanent" penalty tacked on to the premium since you failed to start coverage earlier?
That's one issue. The other is that any other kind of insurance will be very expensive, if available at all.

Now there is one important exception- if you continue to work and get "creditable" coverage (or continue to get coverage from a spouse working) you will not need to get part B, and there will be no penalty when you ultimately do get part B.

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Fri Feb 14, 2020 4:24 pm

FactualFran wrote:
Fri Feb 14, 2020 3:57 pm
With the highest additional amount, the Medicare Part B premium covers 85% of what the government pays in benefits. The standard premium covers 25%.
I have the impression that Medicare reimbursement rates are lower than private insurance. So I still believe you cannot find cheaper equivalent insurance.

We do pay IRMAA, although not at the highest level. I consider it a charitable gift to help those that could not afford Medicare otherwise.

Wricha
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Re: Medicare vs IRMAA vs health care coverage

Post by Wricha » Fri Feb 14, 2020 4:41 pm

Is one allowed to buy healthcare insurance if they are eligible for Medicare?

jj
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Re: Medicare vs IRMAA vs health care coverage

Post by jj » Fri Feb 14, 2020 8:54 pm

ps56k wrote:
Fri Feb 14, 2020 2:34 pm

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491
Take your IRMAA amount for the top tier $491, add in a low cost Part D (drug plan) for $15 and a Mutual of Omaha supplement, Plan G, with very comprehensive coverage with <$200/year deductible for $98 - this is for a 65-year-old male in my zip code. Total = $604 per month.

Compare that to the price of a 'private' Bronze ACA compliant policy with a much smaller doctor/hospital network and a whacking great $8150/year deductible for $698 per month - this is for a 60-year-old, non-smoker in my zip code. For similar, but slightly worse, coverage to Medicare, I could have bought a much more comprehensive Gold ACA policy at >$1500 a month.

I can't wait to be old enough to qualify for Medicare pricing!
...it is madness to risk losing what you need in pursuing what you simply desire. Warren E. Buffett

mhalley
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Re: Medicare vs IRMAA vs health care coverage

Post by mhalley » Fri Feb 14, 2020 9:06 pm

My insurance co sent me a premium for what my age 65 yo bronze plan for my wife and I would be. Over $3200 a month, for a plan that would not pay a dime for ANYTHING until 6k deductible. The maximum Medicare plus IRMAA plus part d would be about $1544 plus say $220 for supplement maybe? So $1400 cheaper.

ralph124cf
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Re: Medicare vs IRMAA vs health care coverage

Post by ralph124cf » Sat Feb 15, 2020 5:40 am

jj wrote:
Fri Feb 14, 2020 8:54 pm
ps56k wrote:
Fri Feb 14, 2020 2:34 pm

MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 + .....= $491
Take your IRMAA amount for the top tier $491, add in a low cost Part D (drug plan) for $15 and a Mutual of Omaha supplement, Plan G, with very comprehensive coverage with <$200/year deductible for $98 - this is for a 65-year-old male in my zip code. Total = $604 per month.

Compare that to the price of a 'private' Bronze ACA compliant policy with a much smaller doctor/hospital network and a whacking great $8150/year deductible for $698 per month - this is for a 60-year-old, non-smoker in my zip code. For similar, but slightly worse, coverage to Medicare, I could have bought a much more comprehensive Gold ACA policy at >$1500 a month.

I can't wait to be old enough to qualify for Medicare pricing!
In addition to the max Medicare part B IRMAA of $491, there is a max IRMAA of $76.40 for part D, drug coverage.

Ralph

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Stinky
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Re: Medicare vs IRMAA vs health care coverage

Post by Stinky » Sat Feb 15, 2020 1:57 pm

If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
It's a GREAT day to be alive - Travis Tritt

Wricha
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Re: Medicare vs IRMAA vs health care coverage

Post by Wricha » Sat Feb 15, 2020 4:07 pm

Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.

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Stinky
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Re: Medicare vs IRMAA vs health care coverage

Post by Stinky » Sat Feb 15, 2020 4:44 pm

Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
This is one facet of the on-again/off-again push to make the tax code more progressive. It’s similar to assessing Medicare taxes on all wages, even though everyone receives the same Medicare benefits.

I’m not making a political statement, and not saying whether I agree with it or not. It’s just a fact - politicians often feel “the ‘rich’ can afford to pay more.”
It's a GREAT day to be alive - Travis Tritt

MJS
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Re: Medicare vs IRMAA vs health care coverage

Post by MJS » Sat Feb 15, 2020 4:50 pm

ps56k wrote:
Fri Feb 14, 2020 2:34 pm
MAGI vs Medicare IRMAA surcharge
0 - 174k.. = $144
174 - 218 = $202
218 - 272 = $289
272 - 326 = $326
326 - 750 = $462
750 +.....= $491
Nitpick time: Non matching data bothers me.
Column 1 = income of a couple filing jointly
Column 2 = Medicare pt B & IRMAA for one person
Revise to Column 2 to
Medicare Pt B & IRMAA + Medicare Pt D IRMAAs for 2
0 - 174k.. = $288
174 - 218 = $404+24
218 - 272 = $578+63
272 - 326 = $652+101
326 - 750 = $924+140
750 +..... = $982+153

Dottie57
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Re: Medicare vs IRMAA vs health care coverage

Post by Dottie57 » Sat Feb 15, 2020 4:52 pm

Wricha wrote:
Fri Feb 14, 2020 4:41 pm
Is one allowed to buy healthcare insurance if they are eligible for Medicare?
Once eligible for Medicare I think ACA goes away.

Monster99
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Re: Medicare vs IRMAA vs health care coverage

Post by Monster99 » Sat Feb 15, 2020 4:52 pm

Stinky wrote:
Sat Feb 15, 2020 4:44 pm
Wricha wrote:
Sat Feb 15, 2020 4:07 pm
Stinky wrote:
Sat Feb 15, 2020 1:57 pm
If a Medicare beneficiary has the income to be subject to IRMAA, then he certainly has the ability to pay IRMAA.
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
This is one facet of the on-again/off-again push to make the tax code more progressive. It’s similar to assessing Medicare taxes on all wages, even though everyone receives the same Medicare benefits.

I’m not making a political statement, and not saying whether I agree with it or not. It’s just a fact - politicians often feel “the ‘rich’ can afford to pay more.”
What they fail to do is define exactly what level is "rich".....

cas
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Re: Medicare vs IRMAA vs health care coverage

Post by cas » Sat Feb 15, 2020 5:22 pm

Wricha wrote:
Sat Feb 15, 2020 4:07 pm
So if a person has income more than you they should pay more for a “benefit” ? Given that they more than likely paid more than you during their entire working career for Medicare. Just trying to understand the logic.
Unfortunately, the Medicare payroll tax funds Medicare Part A (hospitalization benefits) only. Everyone who is eligible (they or spouse paid 40 quarters of SS/Medicare payroll tax) gets 100% of their Part A premium paid. People with less than 40 quarters pay a premium for Part A.

Medicare Part B (doctor, outpatient benefits) and Medicare Part D (prescription benefits) were introduced in different legislation and have different funding mechanism. They are paid out of combination of premiums and "general revenues of the United States" (i.e. income taxes.) IRMAA determines how much of a subsidy a person gets off the Medicare B/D premiums. Everyone over 65 who is eligible to buy B/D , no matter what their income is, gets at least a 15% subsidy off the "true cost" of the Medicare B/D premium. Most people (the 90% -95% whose income falls in the first IRMAA tier) get a 75% subsidy off the premiums. The various IRMAA tiers determine whether the subsidy for the B/D premium is 75%, 65%, 50%, 35%, 20%, or 15%.

prd1982
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Re: Medicare vs IRMAA vs health care coverage

Post by prd1982 » Sat Feb 15, 2020 5:28 pm

CAS,

Thanks for the explanation.

quantAndHold
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Re: Medicare vs IRMAA vs health care coverage

Post by quantAndHold » Sat Feb 15, 2020 6:06 pm

Even if you can find alternative insurance, IRMAA is going to be cheaper than any of the alternatives.

notinuse
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Re: Medicare vs IRMAA vs health care coverage

Post by notinuse » Sat Feb 15, 2020 6:24 pm

Medicare Part B is subsidized for most people. IRMAA is a reduction of that subsidy if your income is high enough. The medicare part of payroll tax paid when employed is for Part A, not Parts B or D.

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