IRMAA Help and Appeals: Lower Your Medicare Premiums

If your Medicare premiums are higher than you expect, you may be dealing with IRMAA—the Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Part B and Part D premiums if your income from two years ago is over a certain limit.

Good news: if your income has dropped—especially if you recently retired—you may qualify to appeal and lower your surcharge.

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What Is IRMAA?

IRMAA is a monthly surcharge added to your Medicare Part B (doctor & outpatient coverage) and Part D (prescription drug coverage) if your income exceeds certain thresholds. It’s based on your tax return from two years ago—not your current income.

That means a life change—retirement, reduced income, death of a spouse—could leave you paying too much today. Learn more in our full explainer: Understanding IRMAA.

How Is IRMAA Calculated?

IRMAA is determined from your MAGI (Modified Adjusted Gross Income), which is your AGI plus certain tax-exempt items. Your 2024 return determines your IRMAA in 2026.

Here are projected 2026 thresholds (pending final SSA/CMS numbers):

  • Single filers: ~$107,000
  • Married filing jointly: ~$214,000

These are inflation-indexed and subject to change. For a deeper dive into what counts toward IRMAA and bracket details, visit: IRMAA Thresholds & MAGI Details.

How IRMAA Affects Medicare Premiums

IRMAA doesn’t just tweak your payment—it can add a significant surcharge to your normal Medicare premiums.

  • Part B: Your base premium (projected $206.50 for 2026) + IRMAA surcharge if applicable.
  • Part D: Your drug plan premium + a separate IRMAA add-on billed by Medicare.

Let’s say your income placed you in a higher bracket—you’d pay more every month for both medical and prescription benefits. And it doesn’t matter whether you use Medigap or Medicare Advantage—IRMAA applies across the board.

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How to Appeal IRMAA

If your income has dropped due to a qualifying life event, you can request a reconsideration (appeal) of your IRMAA surcharge.

Qualifying events include:

  • Retirement or significant income reduction
  • Death or divorce of spouse
  • Loss of pension or wage income
  • Other one-time income events (e.g. stock sale)

To file, use Form SSA-44 and include supporting documents. Appeals go through Social Security. Success can reduce or remove your surcharge. Detailed guidance here: IRMAA Appeals for High-Income Retirees.

How to Plan Ahead for IRMAA

IRMAA may feel like a hidden tax, but with proactive planning you can soften its blow.

  • Time retirement withdrawals, Roth conversions, or capital gains carefully to avoid income spikes.
  • Coordinate benefits timing. Remember: your 2024 income is what impacts your 2026 IRMAA.
  • Keep careful records and track eligibility for appeals if your income changes.

Learn More about IRMAA from Matt’s Blog

Frequently Asked Questions

What is IRMAA and who has to pay it?
IRMAA is an income-based surcharge added to Medicare Part B and Part D premiums when your income from two years ago exceeds certain thresholds. Start with the plain-English explainer: Understanding IRMAA.
How is IRMAA calculated?
Social Security looks at your MAGI (Modified Adjusted Gross Income) from two tax years prior and places you into brackets. See what counts toward MAGI and the latest thresholds here: IRMAA Thresholds & What Counts.
Does IRMAA apply if I have Medicare Advantage or a Medigap plan?
Yes. IRMAA is tied to your income, not your plan type. It applies whether you have Original Medicare + Medigap or a Medicare Advantage plan. Learn how your drug coverage works alongside IRMAA here: What Does Medicare Part D Cover?
Can I appeal IRMAA if my income dropped?
Usually, yes. If you had a life-changing event (retirement, marriage/divorce, death of a spouse, loss of pension, etc.), you can file an appeal with Form SSA-44. Step-by-step help: IRMAA Appeals for High-Income Retirees. Also review recent updates: Changes to the IRMAA Appeals Process.
Do prescriptions I fill affect IRMAA?
Not directly—IRMAA is based on income, not prescription volume. But understanding Part D can prevent other costly mistakes: What Part D Covers.
What are common mistakes people make with IRMAA?
Paying IRMAA for a full year after retiring without appealing, triggering a one-time income spike (large RMDs, asset sales) without planning, or missing paperwork deadlines. Avoid the big pitfalls: Medicare Mistakes to Avoid.
Will the IRMAA rules change again?
Thresholds are inflation-indexed and updated annually. Keep an eye on yearly updates here: Medicare Changes. If you’re picking doctors or pharmacies during plan changes, use the Medicare provider search guide.

Ready to See If You Can Lower Your Medicare Costs?

No pressure. Just a helpful, expert conversation to see if you qualify.

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Disclaimer

This IRMAA appeal service is offered through a third-party consulting firm not affiliated with Medicare, the Social Security Administration, or any government agency. Prepare for Medicare may receive a referral fee if you use their services. This page is for informational purposes only and does not constitute legal, tax, or financial advice. Please refer to our Privacy Policy and Terms of Use.