IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. It is not a penalty — it is a surcharge based on your ability to pay. Most Medicare beneficiaries (about 93%) do not pay IRMAA.

What income does Social Security use to calculate IRMAA?

Social Security uses your Modified Adjusted Gross Income (MAGI) from your federal tax return two years prior. For 2026 premiums, they look at your 2024 tax return. MAGI is your adjusted gross income plus tax-exempt interest income.

Does IRMAA apply to Part D (prescription drug plans) too?

Yes. If your income triggers IRMAA, you will also pay an extra amount on top of your Part D plan premium. The Part D IRMAA surcharge uses the same income brackets but different dollar amounts. The surcharge ranges from about $13 to $81 per month in 2025, depending on your income tier.

How do I know if I owe IRMAA?

Social Security will send you a letter (called an "initial determination") before the start of each year if IRMAA applies to you. The letter explains the surcharge amount and which tax return it is based on. Your Part B premium with IRMAA is automatically deducted from your Social Security benefit.

Can I appeal IRMAA if my income has dropped?

Yes. If you have experienced a life-changing event that significantly reduced your income — such as retirement, job loss, divorce, or death of a spouse — you can file Form SSA-44 to request that Social Security use your more recent (lower) income instead of the two-year-old tax return. You can submit the form online, by mail, or in person at your local Social Security office.

What is the SSA-44 form?

Form SSA-44 is the official form to request a reduction in your IRMAA surcharge. It is titled "Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event." You use it to report a qualifying life-changing event and provide evidence of your reduced income. Download it at ssa.gov/forms/ssa-44.pdf.

No. IRMAA is recalculated every year based on your most recent tax return available to the IRS (two years prior). If your income drops below the threshold in a future year, the surcharge goes away. You can also request a new determination at any time if a life-changing event lowers your income.

Does selling my house trigger IRMAA?

It can. If the capital gain from selling your home pushes your MAGI above the IRMAA threshold for that tax year, you may owe the surcharge two years later. However, the first $250,000 of gain ($500,000 for married couples) on a primary residence is typically excluded from taxable income. A one-time spike usually only affects one year of IRMAA.

IRMAA Explained: Medicare's Income-Related Surcharge (2026)

By Anthony Orner, Licensed Medicare Insurance Broker · Updated March 2026

In plain English

If you earn above a certain amount, Medicare charges you extra on your Part B and Part D premiums. This surcharge is called IRMAA. It is based on your tax return from two years ago. If your income has dropped since then, you can appeal.

What Is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional amount that higher-income Medicare beneficiaries pay on top of the standard Part B premium ($185/month in 2026) and their Part D drug plan premium.

About 93% of Medicare beneficiaries pay only the standard premium. IRMAA only applies if your modified adjusted gross income (MAGI) exceeds certain thresholds.

How IRMAA Is Calculated

Social Security determines your IRMAA based on the tax return from two years ago. For your 2026 premiums, they look at your 2024 federal tax return. Specifically, they use your Modified Adjusted Gross Income (MAGI), which is your adjusted gross income plus any tax-exempt interest income.

Why the two-year lookback?

The IRS shares your tax data with Social Security, and the most recent finalized return is typically from two years prior. This means a high-income year in 2024 affects your 2026 premiums — even if your income is lower now.

2025 Part B IRMAA Brackets

The table below shows the monthly Part B surcharge by income level. CMS publishes updated brackets each fall for the following year.

Individual (Single)	Married Filing Jointly	Monthly Surcharge	Total Part B Premium
$106,000 or less	$212,000 or less	$0	$185.00
$106,001–$133,000	$212,001–$266,000	+$70.00	$255.00
$133,001–$167,000	$266,001–$334,000	+$175.00	$360.00
$167,001–$200,000	$334,001–$400,000	+$280.10	$465.10
$200,001–$500,000	$400,001–$750,000	+$385.00	$570.00
Above $500,000	Above $750,000	+$420.80	$605.80

Source: Medicare.gov — Part B Costs. Brackets shown are for 2025; CMS announces 2026 amounts in fall 2025. Married filing separately has different thresholds — see the CMS announcement for details.

Not sure if IRMAA applies to you?

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How to Appeal IRMAA (Form SSA-44)

If your income has dropped significantly since the tax year Social Security is using, you may be able to get the surcharge reduced or eliminated. The process is straightforward:

Confirm you had a qualifying life-changing event

Social Security will only reconsider your IRMAA if your income changed due to a specific qualifying event (see list below). Simply having lower income is not enough — you need a triggering event.

Download Form SSA-44

This is the official form titled "Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event." You can download it, fill it out online at ssa.gov, or pick up a copy at your local Social Security office.

Gather your documentation

You will need proof of the life-changing event (e.g., retirement letter, divorce decree, death certificate) and evidence of your reduced income (e.g., recent pay stubs, pension statement, or a signed statement of expected income).

Submit the form

You can submit online through your my Social Security account, mail the completed form and documents to your local Social Security office, or schedule an appointment to submit in person.

Download the SSA-44 Form (PDF)

This is the official form from the Social Security Administration to request a reduction in your IRMAA surcharge.

Download SSA-44 (PDF) →

Opens ssa.gov in a new tab. You can also file online through your my Social Security account.

Qualifying Life-Changing Events

Social Security will reconsider your IRMAA if one of these events caused your income to decrease:

✓Marriage or divorce

✓Death of a spouse

✓You or your spouse stopped working or reduced work hours

✓Loss of income-producing property (due to disaster, etc.)

✓Loss of pension income

✓Employer settlement or closure

What does NOT qualify

A one-time spike in income (like selling a home or a Roth conversion) does not qualify as a life-changing event. However, since IRMAA is recalculated each year, the surcharge from a one-time event will typically only last for one year.

Questions About IRMAA? Call Free — 855-559-1700

IRMAA — Frequently Asked Questions

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