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  • Medicare insurance is available for anyone over the age 65
  • There are many facets to Medicare insurance plans
  • Medicare is based upon your yearly income


The cost of Medicare insurance depends on your work history.  Those who have Medicare need to pay for the hospital insurance (Part A) and medical insurance (Part B).

If you have a spouse who worked and paid for Medicare insurance for ten years or more, you will pay nothing for Part A. However, everyone is required to a monthly premium for the Part B (medical insurance).

If you or your spouse has worked and paid taxes for Medicare for seven and a half years to ten years, you need to pay $248 every month. If the number of years that you have worked and paid Medicare taxes is lower than seven and a half years, you need to pay $450 and $115.40 each month for Part B.

If your annual income is below $85,000 for singles and $170,000 for couples. These costs usually go up each year. For people with higher incomes, they are required to pay a higher premium for Part B.

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Will I pay a higher premium if my income is higher?


Definitely yes! Effective January 1, 2010, the Medicare Part B premium is higher if your income is above $85,000 per year for singles and $170,000 per year for a couple. The income referred here is the adjusted gross income reported and other income that are tax-exempt. Your Part B premium will depend on how high your income is.

Moreover, your Part B premium will also depend on when you began receiving Part B and whether or not it was taken out of the Social Security check. The law provides that the Part B premium cannot be increased if it will decrease your Social Security check.

There has been no increase in Social Security benefits (Cost of Living Adjustment) for the year 2011, so the Part B premium of those who had their premium taken out in December 2010 will not go up except, of course, if their incomes are above $85,000 for singles and $170,000 for couples.

How much Part B premium will I pay if my income is higher?

  • For those individuals earning $85,001 to $107,000 annually and combined earnings of $170,001 to $214,000 for couples, they will pay $161.50 per month.
  • A monthly premium of $230.70 is required for individuals with an annual income of $107,001 to $160,000 and for couples $214,001 to $320,000 combined incomes.
  • A monthly premium of $299.70 is required for individuals with annual earnings of $160,001 to $214,000 and for couples, $320,001 to $428,000.
  • For those earning above 214,000 for individuals and above $428,000 for couples will need to pay a monthly premium of $369.10.

Can I make an appeal if I think I should not be paying so much for my monthly premium?

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In cases when you think you are being charged higher than what you earn, you can go to the local Social Security office and show proof of your actual income. There is a probability that discrepancies may happen because Social Security may be looking at an old tax return or your status or financial earnings have changed. Discrepancies may happen when:

  • You have become divorced or married
  • Your spouse died
  • You reduced your working hours
  • You or your spouse have stopped working
  • You have lost a property that was earning an income
  • Your benefits from a pension plan went down or totally stopped

What documents should I show as proof of my change of income?

Before Social Security changes your category, you must present evidence that your income is lower than they claim or it has changed. Some of the evidence that you could present are a signed copy of the tax return indicating a change in the income.

In cases where your marital status has changed, you can present a death certificate or a marriage certificate.

If your employment status has changed, you can provide a letter from your employer confirming your retirement, resignation, or termination. In the event that you have lost a property that was earning you an income, you can present an insurance claim for the property damage.

What form will I use to present these documents?

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This should be accomplished with the use of form SSA-44, which you can request from the Social Security office, either through phone or by downloading it from the agency’s website. When filing this form, you either should provide original documents or certified true copies. The agency will return the documents after they have been reviewed.

In the event that Social Security is convinced and satisfied with the evidence you have presented, it will revise its record and correct your Part B premium payments.

However, if Social Security is not satisfied with the proof presented, it will deny your request and you will continue to pay the premium that the agency claims that you should pay. The agency reviews your income each year and adjusts the Part B premiums correspondingly.

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[su_spoiler title=”References:” icon=”caret-square” style=”fancy” open=”yes”]

  1. https://www.healthcare.gov/medicare/
  2. https://www.youtube.com/watch?v=SYeY2MdCpfw
  3. https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/…
  4. https://www.healthcare.gov/health-coverage-exemptions/forms-how-to-apply/
  5. https://www.ssa.gov/medicare/


Categories: FAQ