
If you're in the "holdharmless" group, it's because you're not new to Medicare in 2011, and your income (modified AGI in 2009) is no more than $85,000. Otherwise, you're in another column. Note the income break points in the table. It makes sense to micro-manage your income if your AGI falls close to a breakpoint.
For example, make $85,001 (if you made only $85,000 in the previous year) and that extra dollar will net you about $58 per month, or about $700 per year, in extra Medicare Part B premium compared with the hold-harmless premium. That's a marginal tax rate of 78,000% on the last dollar (at least I think it is...it's hard for me to calculate high percentages.)
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