Part D (Prescription Drug) Cost Details
The chart below shows your estimated part B monthly premium based on your income as reported on your IRS tax return. If your income is above a certain limit, you'll pay an income-related monthly adjustment amount in addition to your part B premium.
| If your filing status and yearly income in 2019 was |
| File individual tax return | File joint tax return | File married & separate tax return | You pay each month (in 2021) |
| $88,000 or less | $176,000 or less | $88,000 or less | your plan premium |
| above $88,000 up to $111,000 | above $176,000 up to $222,000 | not applicable | $12.30 + your plan premium |
| above $111,000 up to $138,000 | above $222,000 up to $276,000 | not applicable | $31.80 + your plan premium |
| above $138,000 up to $165,000 | above $276,000 up to $330,000 | not applicable | $51.20 + your plan premium |
| above $165,000 and less than $500,000 | above $330,000 and less than $750,000 | above $88,000 and less than $412,000 | $70.70 + your plan premium |
| $500,000 or above | $750,000 and above | $412,000 and above | $77.10 + your plan premium |
Back