Medicare premiums are an important expense to consider when planning for retirement. While many Medicare beneficiaries pay only the standard Part B premium, taxpayers with higher incomes may face additional monthly costs for Part B and Part D premiums known as the Income-Related Monthly Adjustment Amount, or IRMAA. The Social Security Administration (SSA) manages IRMAA and applies it when a beneficiary’s modified adjusted gross income, or MAGI, exceeds specific federal thresholds.

Taking the time to understand how IRMAA works can help you stay informed and plan more effectively for your potential Medicare costs.

How Do IRMAA Thresholds Work?

The SSA calculates IRMAA surcharges using income data from your federal tax return submitted two years prior, following the mandatory two-year lookback rule. For example, 2026 Medicare Part B premiums are calculated using MAGI reported on 2024 federal tax returns.

IRMAA operates on a tier-based sliding scale that increases as income rises:

Single Filers

In 2026, standard Medicare premiums apply to single filers with a MAGI of $109,000 or less. If your income exceeds this amount, surcharges kick in at Tier 1 and increase for higher income brackets.

For Medicare Part B, additional surcharges can range from $81.20 to $487 per month.

For Medicare Part D, the additional monthly amount ranges from $14.50 to $91 per month.

Married Filing Jointly

For married couples filing jointly, standard Medicare premiums apply to couples with a MAGI of $218,000 or less. Joint income above $218,000 triggers the surcharge ranges mentioned above.

Because IRMAA uses specific income brackets, even a relatively small increase in income can push a beneficiary into a higher surcharge bracket for the entire year.

For more details on income levels and surcharges, visit Medicare.gov.

Can I Reduce IRMAA Surcharges?

For some retirees, the IRMAA determination may not accurately reflect their current financial situation because of the two-year delay. For instance, a recent retiree whose earnings dropped significantly after they stopped working could still be charged based on peak pre-retirement salary. 

Fortunately, you don’t have to pay inflated rates if your income decreased after certain qualifying life-changing events. By submitting Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event), beneficiaries can ask the SSA to calculate premiums using recent, or estimated, income rather than outdated tax data.

Qualifying Life-Changing Events

Not every decrease in income qualifies for a new IRMAA determination. Form SSA-44 strictly requires specific, qualifying life events to warrant a recalculation, including:

• Work stoppage or work reduction (retirement or shifting to part-time)
• Marriage, divorce, or annulment
• Death of a spouse
• Loss of pension income or employer settlement payments
• Loss of income-producing property due to disaster, fraud, or theft

To qualify, your circumstances must meet SSA’s requirements, and supporting documents may be required.

Requesting a New IRMAA Determination with Form SSA-44

To submit an appeal:

1. Identify the Event: Indicate the specific life-changing event and note the date it occurred.
2. Report New Income: Provide the updated MAGI and filing status for the more recent tax year.
3. Gather Verification: Attach certified or original documentation proving both the event (such as a retirement letter or death certificate) and updated income (such as a recent tax return).
4. Submit to the SSA: Mail or deliver the completed form and supporting documents to your local Social Security office.

Submitting Form SSA-44 does not guarantee a reduction or elimination of your IRMAA. The Social Security Administration will review your information to determine if you qualify for a new assessment. If the SSA approves your request and decides that a lower IRMAA applies, your premiums will be adjusted retroactively, and any amounts that were overpaid will be refunded.

Keep IRMAA in Mind When Planning for Retirement

IRMAA (Income-Related Monthly Adjustment Amount) is one of several factors that can influence the cost of Medicare in retirement. Understanding how your income affects these surcharges, identifying where you fall within the applicable thresholds, and recognizing when a qualifying life-changing event may allow you to request a new determination can help you prepare for potential Medicare expenses.

As your income and circumstances evolve, it is important to periodically review how these changes may impact your Medicare premiums. This practice is an important part of keeping your overall financial plan aligned with your current situation.

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