A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource
  • Menu
  • Home
  • Contact
  • MAPD
  • PDP
  • 2024
  • 2025
  • FAQs
  • Articles
  • Search
  • Contact
  • 2024
  • 2025
  • FAQs
  • Articles
  • Latest Medicare News
  • Search

Can I be assessed Part D IRMAA if I am not enrolled in a Medicare drug plan?

Category: IRMAA: Higher Incomes and Costs
Updated: Jan, 22 2024


No.  You should not pay an Income-Related Monthly Adjustment Amount (IRMAA) for Medicare Part D if you are not enrolled in a Medicare Part D drug plan (for example, you have no drug coverage or you get your supplemental drug coverage through the VA or Tricare).

As noted by the Centers for Medicare and Medicaid Services (CMS):
"If an individual does not have or no longer has Medicare prescription drug coverage, they shouldn’t be charged the Part D-IRMAA."
And when your Part D IRMAA is wrongly assessed . . .

If the Social Security Administration has made an error when assessing you Part D (or Part B) IRMAA - or if you have had a change in financial status and no longer fall into the annual IRMAA categories, you might consider appealing your IRMAA or asking for a reconsideration of your IRMAA.

We have information online about appealing IRMAA here:
Q1FAQ.com/544

and here:
q1medicare.com/PartD-IRMAAReconsiderationAppealsPartD.php


Question:  But, I do not have a Medicare drug plan so why am I still paying Part D IRMAA?

You actually have Medicare Part D drug coverage in another form.

Quite often people are assessed Part D IRMAA because they are actually enrolled in some form of “supplemental” prescription drug coverage that is equivalent to a Medicare Part D plan.

For example, if you are enrolled in a prescription drug plan through a Medicare Advantage plan (MAPD) - or an employer health or drug plan - or union health plan - or retiree healthcare coverage - you will need to pay Part D IRMAA, if your plan includes "creditable" prescription drug coverage.

Question:  I really do not have any drug coverage, so why am I getting the IRMAA assessment?

You may have mistaken your Part B IRMAA payment for a Part D IRMAA assessment.

If you are a higher-earning Medicare beneficiary and enrolled in Medicare Part B, you will also be charged IRMAA for your Medicare Part B coverage - and sometimes people without any drug coverage mistake their Part B IRMAA payment for a Part D IRMAA assessment.

Question:  Why did I receive a bill for IRMAA even though I disenrolled from my Medicare drug plan?

It is possible that you are still paying your past-due Part D IRMAA from a previous Medicare drug plan.

The same CMS memo noted above continues on to note that "if someone didn’t pay the Part D-IRMAA that was owed before disenrolling from their prescription drug coverage, they are responsible for the past due amount."

So if you did not pay your past IRMAA for your Medicare Part D plan coverage, you can still be assessed Part D IRMAA for the unpaid portion or past-due IRMAA - even though you are no longer enrolled in a Medicare Part D plan.


See the related Frequently Asked Question:

Can I be disenrolled from my Medicare prescription drug plan if I refuse to pay my Medicare Part D IRMAA?

(Spoiler Alert: . .  Yes.)

Need further assistance?

If you still need more information about the income-related monthly adjustment amounts (IRMAA), you can visit a local Social Security office or visit www.socialsecurity.gov/mediinfo.htm, or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Sources include:
Part D-Income Related Monthly Adjustment Amount—Frequently Asked Questions & Answers, from Anthony Culotta, Director Medicare Enrollment & Appeals Group, December 10, 2010)





Medicare Supplements
fill the gaps in your
Original Medicare
1. Enter Your ZIP Code:
» Medicare Supplement FAQs


Browse FAQ Categories


Ask a Pharmacist*
Have questions about your medication?

» Answers to Your Medication Questions, Free!
Available Monday - Friday
8am to 5pm MST
*A free service included with your no cost drug discount card.




Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.