How to Get $144 Back From Medicare

Medicare Part B premiums can experience adjustments, sometimes resulting in beneficiaries receiving a credit or refund. A notable instance occurred in 2022, where many individuals saw an adjustment that provided a benefit equivalent to $144. Medicare premiums are subject to annual review and influenced by various factors. This 2022 adjustment was a unique event, distinct from routine annual updates.

Understanding the 2022 Medicare Part B Premium Adjustment

Initially, the Centers for Medicare & Medicaid Services (CMS) set the standard monthly premium at $170.10 for 2022, an increase from $148.50 in 2021. This increase was partly influenced by the anticipated costs of Aduhelm, an Alzheimer’s drug, priced at $56,000 per year.

Biogen, Aduhelm’s manufacturer, reduced the drug’s price by approximately 50% to $28,200 annually in late 2021. Concurrently, CMS finalized its National Coverage Determination for Aduhelm and similar drugs, limiting coverage primarily to beneficiaries in approved clinical trials. These changes significantly lowered projected Medicare spending.

The Department of Health and Human Services (HHS) Secretary instructed CMS to reevaluate the 2022 Part B premium. While a mid-year adjustment was not feasible for 2022, CMS incorporated the savings into the 2023 premium calculation. This resulted in a lower-than-expected 2023 premium, effectively passing the savings back to beneficiaries. The standard monthly premium for 2023 decreased to $164.90, a $5.20 reduction from the 2022 rate. This reduction, combined with the earlier overestimation, translated to an approximate $144 benefit for many beneficiaries over 2023.

Who Received the 2022 Premium Refund or Credit

Most Medicare Part B beneficiaries received the 2022 premium adjustment. Individuals paying the standard monthly premium of $170.10 benefited from the reduction in the 2023 premium, paying less than they would have otherwise.

Beneficiaries subject to the Income-Related Monthly Adjustment Amount (IRMAA) also benefited. IRMAA is an additional premium for higher-income individuals, based on their modified adjusted gross income (MAGI) from two years prior. Though their base premium was higher due to IRMAA, the overall reduction in the standard Part B premium for 2023 still provided a proportionate saving.

Individuals enrolled in Medicare Savings Programs (MSPs) also saw the adjustment’s positive impact. MSPs are state-run programs that help low-income Medicare beneficiaries with their Medicare costs, including Part B premiums. For those whose Part B premiums were paid by a state MSP, the lower 2023 premium reduced the financial burden on state programs. This adjustment was automatically factored into premiums for most eligible beneficiaries in 2023, requiring no action.

How the 2022 Refund or Credit Was Issued

The 2022 Medicare Part B premium adjustment was issued as a lower premium amount in 2023, not a direct refund. CMS determined a mid-year adjustment for 2022 was not feasible. Instead, savings from lower-than-anticipated spending were factored into the 2023 Part B premium calculation.

For beneficiaries whose Medicare Part B premiums were deducted from Social Security or Railroad Retirement Board (RRB) benefits, the adjustment appeared as a reduced deduction starting January 2023. Their monthly benefit statements reflected the new, lower Part B premium, resulting in a higher net payment.

Individuals who paid premiums directly, via direct debit or bill, also saw the adjustment in their billing. Their 2023 invoices reflected the lower standard premium of $164.90, reducing their out-of-pocket monthly expense.

For beneficiaries whose Medicare Part B premiums were paid by a state Medicare Savings Program (MSP), the adjustment directly benefited the state. MSPs paid the reduced premium, leading to lower state expenditures. Beneficiaries continued to receive Part B coverage without interruption or higher costs.

Ongoing Ways to Lower Medicare Part B Premiums

While the 2022 Medicare Part B premium adjustment was a specific, one-time event, several ongoing federal and state programs can help beneficiaries reduce their Medicare Part B premiums. These programs are designed to assist individuals with limited incomes and resources in affording their healthcare costs. Applying for these programs provides substantial financial relief.

One significant avenue for premium reduction is through Medicare Savings Programs (MSPs), administered by state Medicaid agencies. There are several categories of MSPs, each with different eligibility criteria and levels of assistance:

• The Qualified Medicare Beneficiary (QMB) Program helps pay for Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments.
• The Specified Low-Income Medicare Beneficiary (SLMB) Program covers the Part B premium for eligible individuals.
• The Qualifying Individual (QI) Program also covers the Part B premium but has slightly higher income limits.
• The Qualified Disabled and Working Individuals (QDWI) Program is designed for certain disabled individuals under age 65 who lost their Social Security disability benefits and Medicare Part A due to returning to work, helping them pay their Medicare Part A premiums.

Eligibility for MSPs is based on income and resource limits, which vary by state and are updated annually. Generally, individuals apply for these programs through their state’s Medicaid office, providing documentation of their income, assets, and household size. It is advisable to contact the state Medicaid agency directly or a local State Health Insurance Assistance Program (SHIP) for specific income and resource thresholds and application guidance. Additionally, the Low-Income Subsidy (LIS), also known as “Extra Help,” can assist with Medicare Part D prescription drug plan costs, including premiums, deductibles, and copayments, providing further financial support for healthcare expenses.