§ 418.2120
How do we determine your income-related monthly adjustment amount?
(a) We will determine your income-related monthly adjustment amount by using your tax filing status and modified adjusted gross income.

(b) Tables of applicable percentage. The tables in paragraphs (b)(1) through (b)(3) of this section contain the modified adjusted gross income ranges for calendar years 2011 through and including 2017, 2018, and 2019, and the corresponding percentage of the cost of basic Medicare prescription drug coverage that individuals with modified adjusted gross incomes that fall within each of the ranges will pay. The monthly dollar amounts will be determined by CMS using the formula in section 1860D-13(a)(7)(B) of the Act. Based on your tax filing status for the tax year we use to make a determination about your income-related monthly adjustment amount, we will determine which table is applicable to you. We will use your modified adjusted gross income to determine which income-related monthly adjustment amount to apply to you. The dollar amounts used for each of the ranges of income-related monthly adjustment will be set annually after 2019 as described in paragraph (c) of this section. The modified adjusted gross income ranges will be adjusted annually after 2019 as described in § 418.2115(e).

(1) General tables of applicable percentages. If your filing status for your Federal income taxes for the tax year we use is single; head of household; qualifying widow(er) with dependent child; or married filing separately and you lived apart from your spouse for the entire tax year, we will use the general tables of applicable percentages. When your modified adjusted gross income for the year we use is in the range listed in the left column in the following tables, you will pay an amount based on the percentage listed in the right column, which represents a percentage of the cost of basic Medicare prescription drug coverage.

Table 1 to paragraph (b)(1): Modified adjusted gross income effective in 2011-2017
Beneficiarypercentage
(percent)
Greater than $85,000 but less than or equal to $107,000
35

Greater than $107,000 but less than or equal to $160,000
50

Greater than $160,000 but less than or equal to $214,000
65

Greater than $214,000
80

Table 2 to paragraph (b)(1): Modified adjusted gross income effective in 2018
Beneficiarypercentage
(percent)
Greater than $85,000 but less than or equal to $107,000
35

Greater than $107,000 but less than or equal to $133,500
50

Greater than $133,500 but less than or equal to $160,000
65

Greater than $160,000
80

Table 3 to paragraph (b)(1): Modified adjusted gross income effective beginning in 2019
Beneficiarypercentage
(percent)
Greater than $85,000 but less than or equal to $107,000
35

Greater than $107,000 but less than or equal to $133,500
50

Greater than $133,500 but less than or equal to $160,000
65

Greater than $160,000 but less than $500,000
80

Greater than or equal to $500,000
85

(2) Tables of applicable percentages for joint returns. If your Federal tax filing status is married filing jointly for the tax year we use and your modified adjusted gross income for that tax year is in the range listed in the left column in the following tables, you will pay an amount based on the percentage listed in the right column, which represents a percentage of the cost of basic Medicare prescription drug coverage.

Table 1 to paragraph (b)(2): Modified adjusted gross income effective in 2011-2017
Beneficiarypercentage
(percent)
Greater than $170,000 but less than or equal to $214,000
35

Greater than $214,000 but less than or equal to $320,000
50

Greater than $320,000 but less than or equal to $428,000
65

Greater than $428,000
80

Table 2 to paragraph (b)(2): Modified adjusted gross income effective in 2018
Beneficiarypercentage
(percent)
Greater than $170,000 but less than or equal to $214,000
35

Greater than $214,000 but less than or equal to $267,000
50

Greater than $267,000 but less than or equal to $320,000
65

Greater than $320,000
80

Table 3 to paragraph (b)(2): Modified adjusted gross income effective beginning in 2019
Beneficiarypercentage
(percent)
Greater than $170,000 but less than or equal to $214,000
35

Greater than $214,000 but less than or equal to $267,000
50

Greater than $267,000 but less than or equal to $320,000
65

Greater than $320,000 but less than $750,000
80

Greater than or equal to $750,000
85

(3) Tables of applicable percentages for married individuals filing separate returns. If, for the tax year we use, your Federal tax filing status is married filing separately, you lived with your spouse at some time during that tax year, and your modified adjusted gross income is in the range listed in the left column in the following tables, you will pay an amount based on the percentage listed in the right column, which represents a percentage of the cost of basic Medicare prescription drug coverage.

Table 1 to paragraph (b)(3): Modified adjusted gross income effective in 2011-2017
Beneficiarypercentage
(percent)
Greater than $85,000 but less than or equal to $129,000
65

Greater than $129,000
80

Table 2 to paragraph (b)(3): Modified adjusted gross income effective in 2018
Beneficiarypercentage
(percent)
Greater than $85,000
80

Table 3 to paragraph (b)(3): Modified adjusted gross income effective beginning in 2019
Beneficiarypercentage
(percent)
Greater than $85,000 but less than $415,000
80

Greater than or equal to $415,000
85

(c) For each year after 2019, CMS will announce the modified adjusted gross income ranges for the income-related monthly adjustment amount described in paragraph (b) of this section.

[75 FR 75891, Dec. 7, 2010, as amended at 55631, Nov. 3, 2018]