2012 Medicare Prescription Drug Plan (part D) Premium Cost

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 2010 was

File Individual Tax Return                                  File Joint Tax Return                   You pay

$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     $48.10 + Your Plan Premium

above $214,000                                   above $428,000                                $66.40 + Your Plan Premium