Under Medicare Part B, which beneficiaries pay higher monthly premiums than the standard amount?

Why A is correct

All Part B beneficiaries pay a monthly premium, but higher-income beneficiaries are assessed an income-related monthly adjustment amount (IRMAA) that raises their premium above the standard rate. The income thresholds are based on modified adjusted gross income reported on the tax return. The examination objectives note that a monthly premium is paid by all beneficiaries and that high-income beneficiaries are assessed higher premiums, a point tested under AH-III.D.1d. The adjustment is designed so that those with greater means contribute more toward the medical program.

Why the other options are wrong

• B) Enrolling during the General Enrollment Period may delay coverage start, but it does not itself raise the monthly premium.
• C) Using approved physicians affects how claims are paid, not the amount of the Part B premium.
• D) Owning a Medigap policy does not change the Part B premium; it is a separate supplemental product.

Memory hook

IRMAA = higher income, higher Part B premium.

Why A is correct

Part B is not free — every beneficiary pays a monthly premium. Most beneficiaries pay the standard Part B premium, but those with higher modified adjusted gross income pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the base premium, so their total Part B premium is higher. The premium is not health-based and is not ordinarily paid by employers; it is usually deducted from the beneficiary's Social Security benefit or billed directly. The income-linked premium structure is a distinctive Part B fact that the exam likes to test against the free-coverage misconception.

Why the other options are wrong

• B) Part B requires a monthly premium; there is no premium-free status as there is for Part A with sufficient credits, so this option repeats the free-coverage myth.
• C) The beneficiary pays the Part B premium directly or through Social Security deduction; employers do not pay it as a rule, so this option assigns the bill to the wrong party.
• D) Part B premiums are based on income, not on health status or claims experience, so this option invents a rating factor the program never uses.

Memory hook

Part B premium: everyone pays, high earners pay more (IRMAA). Health never sets the price — income does.