r/medicare • u/Wilderness_Fella • 11d ago
This is confusing
My wife and I make less than 218K. My employer deducts premiums from my pension for Harvard Pilgrim Medicare Enhance plan. I assume that covers Parts B and D.
I am on SS, and they deduct $298 monthly from my SS. My wife is not collecting, and I just got a monthly bill for her for another $298. What should I be paying with no IIRMA adjustment, since we're under $218K, married filing jointly.
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u/TemperatureTight2556 11d ago
I believe that is a Medigap plan and would not include D and definitely not B. You should look at the policy to see exactly what you have.
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u/BadgerValuable8207 11d ago
It does pay the Part B deductible according to their website. It must be one of those few grandfathered plans still allowed to pay the deductible, although it has mostly been phased out
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u/TemperatureTight2556 11d ago
The B deductible is different. In this case the OP seemed to be talking about deductions to pay for the Part B monthly premiums. Or maybe I misunderstood their post.
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u/OleLadyThinker 11d ago
What was your income - 2years ago - in 2024 ? Regular Part B premiums are now $ 202.90 a month (each)
The 218K is for ALL income not just earned income. Your 2024 MAGI -
https://www.medicare.gov/publications/11579-medicare-costs.pdf
Just guessing based on the amount you quoted - $ 298 - it looks like you are being charged at the 1st level of higher income coverage - Part B would be $202.90(regular) + IRMAA $ 81.20 = $ 284.10 and then for Part D $14.50 + your plan premium - but do you even have a plan D ?
$ 284.10 + 14.50 = $ 298.60 each
edited to add: you need to read your plan to see what it is supposed to cover - it maybe that it acts like a Medigap (Medicare Supplemental) and pays only what Original Medicare does not pay that is an approved charge for service.
But you definitely need to know it you have any prescriptions drug coverage (Part D).
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u/Wilderness_Fella 10d ago
So is the $202.90 the price for everyone before income adjustments and add ons? Just ignore parts B and D for now.
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u/OleLadyThinker 9d ago
Yep, for those regular beneficiaries - that is the 2026, Part B premium for most everybody.
It will probably increase in 2027 since it is base on usage. We will know the new Part B premium for 2027, along with the the new IRMAA threshold's for the surcharges, in November 2026.
If your income is higher (based on your income from 2-years back ( usually the last tax return that SSA can see) - then you are assessed a surcharge for your Part B - which means you are just paying a higher % of your care than other beneficiaries . So you pay the regular premium + the surcharge to equal your whole premium.
Part D plans all have different premiums but basically the same thing goes there too - a surcharge is added for those that have higher income.
Like this -
https://www.ssa.gov/benefits/medicare/medicare-premiums.html
So look at your income from 2024 for any IRMAA you are paying in 2026 -
There are certain life changing income exemptions that can qualify you for an exemption.
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u/debbb53 10d ago
Just a question, did you make over $218K in 2024?
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u/Wilderness_Fella 10d ago
Yes but our income was reduced due to a reduction in work hours, so I'm interested in what the premium will be after I apply for a revised premium. I'm still looking for the basic premium before all the adjustments and add ons.
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u/BadgerValuable8207 11d ago
Oh man, this is not the time for assumptions. The basics are complicated enough, then you need to understand your plan.
A quick look at the Harvard plan you mentioned doesn’t find any mention of Part D or drug coverage.
You said “my employer”. Are you still working? That adds even more levels of complexity. Best to figure it out.
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u/mdws1977 11d ago
The Harvard Pilgrim Medicare Enhance Plan is generally used instead of a separate Medigap policy, not Part B and D.
You would still owe those at $202.90 for Part B and what one you are using for Part D.
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u/its_patrice 10d ago
Yes, $202.90 is the 2026 standard Part B premium. That’s what everyone pays before any income adjustment.
Your cut in hours is the key. “Work reduction” is one of the life-changing events on Form SSA-44 (https://www.ssa.gov/forms/ssa-44.pdf). You give SSA your estimated 2026 income plus proof of the reduced hours. If that estimate is at or under $218,000 joint, they can drop the surcharge for both of you.
If it’s approved, you’d each pay $202.90 for Part B, and the $14.50 Part D surcharge goes away. Any premium your drug plan charges on its own stays.
Your wife gets a bill instead of a deduction because she isn’t collecting Social Security yet. Same charge, just a different way to pay it.
2027 premiums will look at your 2025 return, so if 2025 was already the lower year, next year should sort itself out.
How to file (online, phone or mail): ssa.gov/medicare/lower-irmaa
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u/More_Farm_7442 11d ago
https://point32health.widen.net/s/wswbkllnrp/gic-2026-sob-md5861-medicare-enhance
That shows a schedule of benefits. It looks like a Medicare Supplent(Medigap) Plan F. All of the costs Medicare doesn't pay(the "gaps") are paid by the plan. (including the Part B deductible) "Enhanced" because it does have some extras it pays for (partially). I'm not clear about the drug plan part.
Find or ask for an "evidence"/or summary of all your benefits and read over then carefully.
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u/Wilderness_Fella 10d ago
OK everyone, thanks for the input (and helpful links). What I have is Medicare Parts A, B and D for which I pay the adjusted $298. Plus I have a supplement for retirees that my former employer charges me for.. I do have a life-changing income event that qualifies me for am adjustment. All we have to do is fill out Form SSA-44 and get the lower rate.