Toni Says: Medicare costs and premiums for 2023 released early | Tampa Bay Times

In October 2022, the Tampa Bay Times ran a "Toni Says" column that we flagged for readers at the time as a nice little Q&A about the upcoming changes in surcharges and income levels. Toni King — the Medicare consultant behind the nationally syndicated column and author of the Medicare Survival Guide — walked through what the newly announced 2023 Medicare numbers meant for real beneficiaries, in the reader-question format that makes her column so approachable.

You can read the original column here: Toni Says: Medicare costs and premiums for 2023 released early (Tampa Bay Times, October 12, 2022).

The headline told half the story on its own: the 2023 Medicare costs were released early. That timing detail, easy to skim past, was genuinely useful for anyone doing year-end retirement income planning — and the numbers themselves carried a rare piece of good news. Below is the context around what the column covered and why those 2023 figures still matter as a reference point today.

In a typical year, CMS announces the coming year's Medicare Part B premium, deductibles, and IRMAA income levels in mid-November — after the annual Medicare open enrollment period is already underway. For 2023, CMS broke the pattern and published the 2023 figures on September 27, 2022 — weeks ahead of schedule and, crucially, before open enrollment opened on October 15.

That sequencing mattered. It meant beneficiaries comparing Medicare Advantage and Part D plans during open enrollment could do the math with the actual 2023 premium and surcharge numbers in hand, rather than estimates. Toni King's column landed right in that window, translating the government fact sheet into plain-English answers.

The early release also paired neatly with the other big number of that season: Social Security's 8.7% cost-of-living adjustment for 2023, the largest COLA in four decades. Retirees got an unusual combination — a historically large benefit increase alongside a Medicare premium that was going down, meaning the COLA would not be eaten up by rising Part B costs the way it so often is.

The centerpiece of the column was the standard 2023 Medicare Part B premium: $164.90 per month, down $5.20 from the $170.10 premium in 2022. The annual Part B deductible also fell to $226, a $7 decrease from $233 in 2022.

A Part B premium decrease is rare — this was the first one in more than a decade. The backstory: the 2022 premium had been pushed up sharply in part to build in contingency reserves for a then-new, expensive Alzheimer's drug that Medicare was evaluating for coverage. When Medicare ultimately limited coverage of the drug and spending came in lower than projected, CMS passed the savings back to beneficiaries in the 2023 premium. We cover that story in more detail on our 2023 Medicare Part B premiums page.

For context alongside the Part B decrease, the 2023 Part A inpatient hospital deductible moved the other direction, rising to $1,600 per benefit period — a reminder that "Medicare costs" are a bundle of moving parts, not a single number. You can see the Part A side on our 2023 Part A deductible page.

The part of the Q&A most relevant to higher-income retirees — and the reason we highlighted the column in the first place — was the change in IRMAA surcharges and income levels for 2023. IRMAA, the Income-Related Monthly Adjustment Amount, is the extra premium that higher-income beneficiaries pay on top of the standard Part B and Part D premiums. If the concept is new to you, start with our overview of Medicare IRMAA.

For 2023, the first IRMAA threshold rose to $97,000 of modified adjusted gross income for single filers and $194,000 for married couples filing jointly — up from $91,000 and $182,000 in 2022. Because the SSA uses MAGI from two years prior, 2023 surcharges were based on 2021 tax returns.

And because Part B IRMAA surcharges are calculated as multiples of the standard premium, the premium decrease pulled the surcharge dollar amounts down roughly 3% as well. The 2023 monthly Part B totals by bracket:

• Up to $97,000 single / $194,000 joint: $164.90 (standard, no surcharge)
• Above $97,000 up to $123,000 single (up to $246,000 joint): $230.80
• Above $123,000 up to $153,000 single (up to $306,000 joint): $329.70
• Above $153,000 up to $183,000 single (up to $366,000 joint): $428.60
• Above $183,000 up to $500,000 single (up to $750,000 joint): $527.50
• $500,000+ single / $750,000+ joint: $560.50

Part D IRMAA followed the same income tiers, adding between $12.20 and $76.40 per month on top of the drug plan's own premium. The complete tables, including filing-separately thresholds, are on our 2023 IRMAA brackets page.

Part of why the Toni Says column is worth following is the format itself. Government fact sheets present premium tables; reader Q&A columns answer the question people actually ask, which is almost always some version of "what does this mean for me?" A retiree reading a CMS bulletin sees six income tiers. A retiree reading Toni King sees a person like themselves asking why their premium notice looks different from their neighbor's.

That gap — between published tables and personal impact — is exactly where most IRMAA surprises happen. The two-year income look-back means a strong earning year, a large Roth conversion, or a one-time capital gain shows up as a Medicare surcharge two years later, when the income event is long forgotten. Beneficiaries who experience a qualifying life-changing event, such as retirement, can appeal their IRMAA determination using Form SSA-44 — a remedy plain-language columns like Toni's have done real service in publicizing.

For financial advisors, the lesson runs the other direction: clients are reading columns like this one and arriving with questions. Being able to show a client precisely where their income lands against the current year's thresholds — and what a proposed withdrawal or conversion does to that position two years out — is the difference between reacting to surcharges and planning around them.

The figures in Toni King's column are now historical: the $164.90 premium and the $97,000/$194,000 thresholds applied to 2023 only, and the brackets have continued to adjust each year since. You can trace the full progression on our historical IRMAA brackets page, and see where the thresholds stand now on the 2025 IRMAA brackets page.

But the structural story the column captured is permanent. Medicare premiums are announced annually, IRMAA thresholds move annually, and every beneficiary's surcharge is set by income decisions made two years earlier. A year like 2023 — premiums down, thresholds up — was a pleasant surprise; other years bring the opposite. The only reliable protection is modeling income against the brackets before the income happens.

That is the work RetirementAdvisorPro was built for: giving financial advisors the tools to project clients' MAGI against current and future IRMAA thresholds, stress-test Roth conversions and withdrawal sequencing, and catch bracket crossings while there is still time to plan around them. Columns like Toni Says explain the rules — planning software turns the rules into decisions.