Medicare has no income limit for enrollment

Unlike Medicaid or other information programs, Medicare does not turn you away based on how much money you earn. You can be a millionaire or have no income at all — if you meet the age or disability requirements, you get Medicare. Income does not determine whether you can join.

However, your income does affect what you pay. Higher earners pay higher premiums for Medicare Part B (doctor visits) and Part D (prescription drugs). This is called Income-Related Monthly Adjustment Amount, or IRMAA. It is the main place where income matters in Medicare.

Your income also determines whether you can get help paying Medicare costs through programs like Extra Help (for drug costs) or Medicare Savings Programs (for premiums and deductibles). Those programs do have income thresholds, and they are where most people run into limits.

Key Takeaways

  • Medicare enrollment itself has no income limit — anyone who meets the age or disability requirement can join, regardless of earnings.
  • Income affects your Part B and Part D premiums through IRMAA, a surcharge that kicks in at higher income levels and increases as income rises.
  • Extra Help and Medicare Savings Programs have income limits, and these vary by state and household size.
  • Income thresholds for information programs are updated each year, so you should check current limits before assuming you do not may have access to.

How IRMAA works and when it applies

If your income exceeds a certain threshold, Medicare adds a surcharge to your Part B and Part D premiums. This surcharge is IRMAA. The threshold changes each year, and it depends on your modified adjusted gross income (MAGI) from two years prior — so in 2024, Medicare looks at your 2022 tax return.

IRMAA applies to both Part B (medical insurance) and Part D (prescription drug coverage). The higher your income above the threshold, the higher the surcharge. For 2024, the income thresholds start at $103,000 for single filers and $206,000 for married couples filing jointly. If you earn above these amounts, you will pay more than the standard premium.

The surcharge can be substantial. A single person earning $150,000 in 2024 pays significantly more than someone earning $103,000. The brackets stack, so each income tier adds an additional amount to your premium. You can see the exact brackets on the Medicare website or by calling Social Security.

If your income drops — because you retire, lose a job, or have a major life change — you can request that Social Security recalculate your IRMAA. This is called a life-changing event. You have 60 days from the event to report it, and Social Security may adjust your surcharge retroactively.

Income limits for Extra Help with drug costs

Extra Help is a federal program that pays some or all of your Part D premiums and out-of-pocket drug costs. It has income limits, and they are higher than the IRMAA thresholds. For 2024, the limit is roughly 150% to 175% of the federal poverty line, depending on household size.

For a single person, that works out to approximately $21,000 to $24,000 per year in gross income. For a married couple, it is roughly $28,000 to $32,000. These numbers change annually. The exact limit depends on your state and the number of people in your household.

Extra Help also has a resource limit — a cap on how much money and property you can own. For 2024, the limit is roughly $8,000 for a single person and $12,000 for a couple. Certain assets, like your home and car, do not count toward this limit.

You can check whether you might may have access to by using the Extra Help pre-screening tool on the Social Security website, or by contacting your local Social Security office. If you think you may have access to, you will need to provide recent tax returns, pay stubs, and bank statements to prove your income and resources.

Income limits for Medicare Savings Programs

Medicare Savings Programs (MSP) help pay your Part A and Part B premiums, deductibles, and copayments. Each state runs its own program, and income limits vary by state. Generally, they are set at 120% to 200% of the federal poverty line, depending on which program you are in.

For 2024, a single person earning roughly $18,000 to $30,000 per year might may have access to, depending on the state and the specific program. A married couple might may have access to with income between $24,000 and $40,000. These are approximate ranges; your state's exact limits are available through your state Medicaid office.

Like Extra Help, Medicare Savings Programs have resource limits. These also vary by state but are typically similar to Extra Help — around $8,000 for an individual and $12,000 for a couple. Again, your home and car usually do not count.

To find your state's specific limits and to learn how the process works, contact your state Medicaid office or call 1-800-MEDICARE. You can also visit your state's health department website, which usually has a link to Medicaid or the Medicare Savings Program process.

How to report income changes to Medicare

If your income drops significantly — you retire, lose a job, or have a major life event — you should report it to Social Security within 60 days. This can lower your IRMAA surcharge and may open the door to Extra Help or a Medicare Savings Program.

To report a change, contact Social Security at 1-800-772-1213 or visit your local Social Security office. You will need to explain the change and provide documentation, such as a termination letter from your employer, a divorce decree, or a death certificate if your spouse has passed away.

Social Security will recalculate your MAGI and adjust your Medicare premiums if warranted. The change usually takes effect the month after you report it, though sometimes it can be retroactive if you report within the 60-day window.

Income thresholds that change each year

All of the income limits mentioned here — IRMAA thresholds, Extra Help limits, and Medicare Savings Program limits — change annually. The federal poverty line is adjusted each year, and IRMAA brackets are updated to reflect inflation and other factors.

This means that a threshold that applied in 2023 may not explore in 2024 or 2025. If you were told you do not may have access to for a program last year, it is worth checking again this year. Conversely, if you may have access to last year, you may lose qualification if your income rises or if the threshold drops.

The best way to stay current is to check the official Medicare website (Medicare.gov) or call 1-800-MEDICARE each year when limits are updated, usually in the fall. You can also ask your local Social Security office or state Medicaid office to confirm the current limits for your situation.

Frequently Asked Questions

Can I get Medicare if I have a high income?

Yes. Medicare has no income limit for enrollment. If you are 65 or older, or disabled and have worked long enough to earn Medicare coverage, you can join regardless of how much you earn. Your income may affect your premiums, but it will not prevent you from getting Medicare.

What counts as income for IRMAA purposes?

IRMAA uses your modified adjusted gross income (MAGI) from your tax return from two years prior. This includes wages, self-employment income, interest, dividends, capital gains, and certain other sources. Social Security benefits are not included in MAGI for IRMAA calculations. Your tax return is the main document Social Security uses.

If I am married, does my spouse's income count toward my Medicare limits?

Yes. For IRMAA and most information programs, household income includes both spouses' earnings. If you file taxes jointly, Social Security uses your combined MAGI. If you file separately, each spouse's income is counted separately, which can sometimes lower the surcharge.

What happens if I report my income change late?

If you report a life-changing event more than 60 days after it occurs, Social Security may not adjust your IRMAA retroactively. However, they may still adjust it going forward. It is best to report changes as soon as possible to avoid overpaying premiums you might not owe.

Can I appeal if I think my IRMAA calculation is wrong?

Yes. If you believe Social Security used incorrect income information, you can request a recalculation. You will need to provide documentation, such as tax returns or pay stubs, to support your claim. Contact Social Security or Medicare to start the appeal process.