Part D Monthly Premium
The chart below shows your estimated prescription drug plan monthly premium based on your income. If your income is above a certain limit, you will pay an income-related monthly adjustment amount in addition to your plan premium.
| If Your Yearly Income in 2011 was | You pay | |
|---|---|---|
| File Individual Tax Return | File Joint Tax Return | |
| $85,000 or less | $170,000 or less | Your Plan Premium |
| above $85,001 up to $107,000 | above $170,001 up to $214,000 | $11.60 + Your Plan Premium |
| above $107,001 up to $160,000 | above $214,001 up to $320,000 | $29.90 + Your Plan Premium |
| above $160,001 up to $214,000 | above $320,001 up to $428,000 | $48.30 + Your Plan Premium |
| above $214,000 | above $428,000 | $66.60 + Your Plan Premium |
