What They Are and How They Work

The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an additional charge added to the premiums for Medicare Part B (medical insurance) and Medicare Part D (prescription drug coverage). It only affects beneficiaries whose modified adjusted gross income exceeds $106,000 for individuals or $212,000 for those filing jointly.
How is IRMAA determined?
IRMAA for Medicare Part B and Part D is calculated using a sliding scale based on your income. Medicare reviews the adjusted gross income reported on your tax return from two years prior to determine if the surcharge applies.
What are the income thresholds for IRMAA?
For 2025, IRMAA will apply if your modified adjusted gross income from 2023 exceeds the specified limits.
How Can I Tell If I Have to Pay the Medicare IRMAA?
When you first enroll in Medicare, you will initially pay the standard premiums for Part B and Part D. Social Security reviews your income data from the IRS, and if your income qualifies for IRMAA, they will send you a predetermination notice.
This notice explains:
- That IRMAA will apply to your Medicare premiums.
- How the determination was made.
- What steps to take if the information is incorrect or if your financial situation has changed.
After the predetermination notice, Social Security will send an initial determination notice, confirming that you owe IRMAA on your Part B and Part D premiums (if applicable). This notice also outlines how the decision was made and provides instructions on how to appeal if needed. It’s important to keep this notice for your records.
How Do I Pay the Medicare IRMAA Surcharge?
If you receive Social Security or Railroad Retirement Board (RRB) benefits and your Medicare premiums are already deducted from those payments, IRMAA will be automatically deducted as well.
If you do not have Medicare premiums deducted from Social Security or RRB benefits, you will receive a bill for your Part B and Part D IRMAA charges.
Can I Get My IRMAA Reduced?
If you believe your IRMAA determination is incorrect, you have the right to appeal. To do so, contact the Social Security Administration (SSA) and request a reconsideration of your IRMAA determination. You can call 800-772-1213 to request an appeal form or submit a Request for Reconsideration.
You may not need to file a formal appeal. If your income has decreased or your tax return was amended, you can contact SSA at 800-772-1213 and request a review. You’ll need to provide supporting documents to verify your claim.
If a life-changing event has impacted your income—such as retirement, divorce, or the death of a spouse—you should complete the Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event Form (SSA-44) and submit it by fax or mail to your local Social Security office.
To qualify for an IRMAA adjustment, you must show that the tax return used for the determination was outdated or incorrect due to one of the following reasons:
- An error in IRS data
- Outdated IRS information, and you want more recent income data to be used
- You filed an amended tax return for the year SSA used to calculate IRMAA
- Your income has significantly decreased due to a qualifying life-changing event, such as:
- Death of a spouse
- Marriage, annulment, or divorce
- Reduction or loss of work
- Loss of income from an income-generating property
- Reduction or loss of certain types of pension income