Hold Harmless Rule Protects Social Security From Medicare Premium Increases

In some years, Social Security recipients are protected from having their check lowered due to rising Medicare Part B premiums.

By , J.D. · University of Virginia School of Law

There is a special rule for Social Security recipients, called the "hold harmless rule," that ensures that Social Security checks will not decline from one year to the next because of increases in Medicare Part B premiums. (Medicare Part B pays for outpatient services like doctor visits and medical equipment. Medicare Part B is optional, but most Medicare recipients opt to receive Part B.)

The hold harmless rule applies to most, but not all, Social Security recipients. Most people who receive Social Security disability or retirement benefits and Medicare Part B (coverage for doctor visits) are eligible for protection under this rule. Whether this rule comes into play in a particular year depends on the amount of COLA and the Medicare Part B premium increase.

How Much Is Social Security's COLA?

Every year, an annual cost of living adjustment (COLA) is made to Social Security payments to keep pace with inflation. The idea is to give Social Security recipients enough money so that they can afford higher consumer prices. The COLA is calculated every year and is based on the difference in the consumer price index (CPI) from the end of the third quarter of one year to the next. COLA usually causes Social Security checks to go up, but when consumer prices drop, the COLA is lower or is eliminated altogether.

The past couple of years have had historically high COLAs, but before that, there were some years with low or no COLAs. For 2023 payments, the COLA is 8.7%. And for 2022, the COLA was 5.9%. But for 2021, the COLA was just 1.3%.

How Much Is the Medicare Part B Premium?

Medicare premiums usually rise every year. The monthly premium for Medicare Part B rose to $170.10 in 2022, up from $148.50 in 2021, up from $144.60 in 2020.

But in 2023, the Part B premium is actually going down to $164.90.

When Does the Hold Harmless Rule Take Effect?

When there is a Medicare Part B premium increase and a low or no COLA, as in 2021, the hold harmless rule helps many people. The vast majority of Medicare recipients have their Part B premiums automatically deducted from their Social Security payments every month. When Medicare premiums were climbing each year, without the COLA keeping pace, it was possible for a Social Security recipient to have a reduction in their Social Security check to pay for the increased Medicare premium. Fortunately, the "hold harmless" rule prevented that from happening for most Social Security recipients.

Because of the high COLA for 2022 and 2023 Social Security payments, the hold harmless rule won't take effect in these years.

Who Does the Hold Harmless Rule Protect?

The hold harmless rule applies to all Social Security recipients except the wealthy (defined as those earning $97,000 for an individual or $194,000 for a married couple) and those who are receiving Medicare for the first year. In addition, there are low-income Medicare recipients whose Medicare premiums are paid by their state Medicaid agencies, and those premiums are not protected by the hold harmless provision.

The hold harmless rule also does not apply to the Medicare Part D (prescription drug) premium.

Learn more about Medicare Part B.

Updated December 15, 2022

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