What is IRMAA?

If you’re surprised to see a higher premium for your Medicare Part B or Part D coverage, it might be because of something called IRMAA, the Income-Related Monthly Adjustment Amount. Here’s what it means, who it affects, and what you can do about it.

What Is IRMAA?

IRMAA is an extra amount added to your monthly Medicare premiums if your income is above a certain level. It applies to both Part B (medical coverage) and Part D (prescription coverage) and is based on your modified adjusted gross income (MAGI) from two years ago.

IRMAA is calculated each year in the Fall, so that Medicare beneficiaries will know what premiums to expect before the Open Enrollment Period, October 15 – December 7.

How Does It Work?

The Social Security Administration reviews your tax return from two years prior. So for 2025, your IRMAA is based on your 2023 tax return. IRMAA is reevaluated each year, so if your income goes up or down, your IRMAA amount, and therefore your total monthly Medicare premiums, can increase, decrease, or even be removed entirely the following year. IRMAA is calculated each year as long as you’re enrolled in Medicare Parts B and/or D, but the amount you pay can stop or drop if your income falls below the IRMAA minimum threshold.

IRMAA can be triggered after significant financial events like selling a house, cashing out retirement savings, or receiving a legal settlement. Even if your income has dropped since the event, if those one time funds put you over the threshold, you will pay IRMAA based on your old income.

It’s important to note that you can also appeal the IRMAA amount.  If you’ve had a life-changing event that reduced your income such as retirement, divorce, death of a spouse, or job loss you can request a reconsideration from the Social Security Administration using Form SSA-44. If approved, your IRMAA could be lowered or removed. If you think you’re being charged incorrectly or have had a major life event that impacts IRMAA after the yearly evaluation, don’t hesitate to file an appeal.

Other Things to Know

• IRMAA is not a penalty. It’s an income-based adjustment.
• You’ll get a letter from Social Security explaining your IRMAA and how it was calculated.
• If you delay enrolling in Part B or Part D and are subject to IRMAA, those extra premiums still apply when you enroll.

For more information, premiums and deductibles, please visit Medicare.gov.