Medicare’s Income-Related Premiums: Some beneficiaries will pay a lot more in 2018. You may pay more so physicians can be paid more😷

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)—a new law to repeal and replace Medicare’s Sustainable Growth Rate (SGR) formula for physician payments—includes a provision to increase Medicare premiums for some higher-income beneficiaries to help offset the cost of the law.  

The Congressional Budget Office estimated that this provision would increase Medicare’s premium revenues (and thereby reduce program spending) by $34.3 billion between 2018 and 2025.  This idea is not a new one, having been raised in the context of earlier proposals to reduce federal spending and also included in the Obama Administration’s proposed budgets in recent years.

Source: Medicare’s Income-Related Premiums: A Data Note | The Henry J. Kaiser Family Foundation

The actual dollar amount of these higher premium contributions will depend on the increase in Medicare premiums and  whether or not the amount of any Social Security COLA triggers the hold harmless provision.  

Double the numbers in the chart below for married couples.
Dollar amounts are not adjusted for inflation.


2 replies »

  1. Those with earned incomes in the top 20% will pay considerably more. This principle will almost surely be applied to Social Security reform.


    • The income related additional premiums are based on adjusted gross income whether earned or unearned. I agree that social security will change for higher incomes through either higher taxes and/or decreased benefits. It might not be this year because POTUS said he wouldn’t touch social security or Medicare but it’s coming. The evidence is the 20 trillion dollar Federal debt.


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