Navigating Medicare can sometimes feel overwhelming, especially when unexpected costs pop up. If you’ve heard the term Medicare IRMAA and aren’t sure what it means—or how it might apply to you—you’re not alone.
Here’s a straightforward guide to understanding IRMAA, explained with care, clarity, and expertise.
1. What Does IRMAA Stand For?
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B and/or Part D premiums if your income is above a certain level. Think of it as a surcharge based on your earnings—not everyone pays it, but it’s important to know if you might.
2. Why Does IRMAA Exist?
Medicare costs are partly based on the idea that those with higher incomes can afford to contribute more. If you have a higher reported income, Medicare adjusts your premiums accordingly through IRMAA. This adjustment helps support the overall Medicare program while keeping standard costs lower for most people.
3. How Is IRMAA Calculated?
The amount you pay for IRMAA depends on your modified adjusted gross income (MAGI) from two years ago. For example, your 2025 Medicare costs are typically based on your 2023 tax return.
The Social Security Administration reviews your income and places you into specific brackets. The higher your income, the higher your IRMAA charges will be. Here’s a simple breakdown:
- No IRMAA: Single filers with MAGI $106,000 or less (2025 figures)
- IRMAA tiers: Income above $106,000 results in progressively higher monthly adjustments.
(Income thresholds and IRMAA amounts adjust annually.)
4. Which Parts of Medicare Does IRMAA Affect?
IRMAA impacts two key areas:
- Medicare Part B: Covers doctor visits and outpatient care.
- Medicare Part D: Covers prescription drugs.
You may owe an extra premium for one or both, depending on your income. The IRMAA amount is added to your standard premium—not a replacement. If you join a Part D plan, you pay the Part D IRMAA amount directly to the government (Medicare), not to the Part D insurance company.
5. Can You Appeal an IRMAA Decision?
Absolutely. If you experience a life event that significantly lowers your income—such as retirement, divorce, or the death of a spouse—you can ask for a reconsideration. This process is called Request for Reconsideration and involves submitting form SSA-44 to the Social Security Administration. If approved, your IRMAA charges could be lowered or eliminated.
Bottom Line
Medicare IRMAA can come as a surprise but understanding how it works—and knowing your options if it applies to you—can ease some of the stress. Planning and knowing how to appeal if needed can help you better manage your healthcare costs during retirement.
Need Help Navigating Medicare Costs?
If you have questions about Medicare IRMAA or anything else related to your Medicare coverage, we’re here to help. Schedule a free consultation with one of our trusted Benefit Consultants today—we’ll walk you through everything you need to know, step-by-step.