IRMAA: What It Is, Who Pays It, and How to Get It Lowered
IRMAA is an extra amount added to your Medicare Part B and Part D premiums if your income is over certain thresholds. Social Security uses your tax return from two years ago to decide. If you’ve had a life-changing event that lowered your income (like retirement), you can ask Social Security to recalculate using Form SSA-44 and provide simple proof + a current-year income estimate.
Table of Contents
What is IRMAA?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added on top of your baseline Medicare costs when your income is above set brackets. If it applies to you, your monthly Medicare bill can show up to four line items:
- Part A (usually $0 for most people)
- Part B (everyone pays at least the standard amount)
- Part B IRMAA (if income is high)
- Part D IRMAA (if income is high)
2025 IRMAA Income Brackets
| Single (2023 MAGI) | Married Filing Jointly (2023 MAGI) | Married Filing Separately (2023 MAGI) | Part B IRMAA (Per Month) | Part D IRMAA Amount (Per Month) | Total Monthly Premiums to Medicare |
|---|---|---|---|---|---|
| Less than or equal to $106,000 | Less than or equal to $212,000 | Less than or equal to $106,000 | $0.00 | $0.00 | $185.00 |
| Greater than $106,000 and less than or equal to $133,000 | Greater than $212,000 and less than or equal to $266,000 | — | $74.00 | $13.70 | $272.70 |
| Greater than $133,000 and less than or equal to $167,000 | Greater than $266,000 and less than or equal to $334,000 | — | $185.00 | $35.30 | $405.30 |
| Greater than $167,000 and less than or equal to $200,000 | Greater than $334,000 and less than or equal to $400,000 | — | $295.90 | $57.00 | $537.90 |
| Greater than $200,000 and less than $500,000 | Greater than $400,000 and less than $750,000 | Greater than $106,000 and less than $394,000 | $406.90 | $78.60 | $670.50 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | Greater than or equal to $394,000 | $443.90 | $85.80 | $714.70 |
The two-year lookback (why this gets messy)
Social Security determines IRMAA using your Modified Adjusted Gross Income (MAGI) from two years ago. Example: your 2025 Medicare premiums use your 2023 tax return.
That’s why people who retire mid-year often get assessed at a higher IRMAA based on their old (higher) income—even though their current income is now lower.
When and how you’ll find out
- Before you start Medicare: Check the brackets for the year you’ll enroll to estimate your all-in costs.
- If you’re already on Medicare: Social Security mails an IRMAA determination (often late Nov/Dec) for the upcoming year. The notice shows the income year they used and the monthly amounts.
Can you get IRMAA reduced?
Yes—if a qualifying life-changing event (LCE) lowered your current/next-year income compared to the IRS year Social Security used. You’ll use Form SSA-44 to request a new decision.
If there’s no life-changing event and you think the decision is wrong (e.g., wrong filing status, IRS data mismatch), you use SSA-561 (Reconsideration) instead.
SSA-44: When it applies (plain English)
You likely want SSA-44 if your income dropped due to one of these events:
- Work stoppage (retirement) or work reduction (moving to part-time)
- Marriage (changed filing status + combined income now below thresholds)
- Divorce/annulment
- Death of a spouse
- Loss of income-producing property not at your direction (e.g., fire, theft, condemnation, eminent domain)
- Loss of pension income
- Employer settlement payment (a one-time spike last year; income now back down)
Common situations that do not qualify for SSA-44 (you usually ride it out for the year):
- Voluntary sale of an income-producing property (you chose to sell the rental)
- Roth conversions
- Capital gains or large but ordinary bonuses
- Lottery/casino winnings
Quick rule: SSA-44 is for listed life-changing events that reduced your income. One-time income spikes you chose (like a voluntary sale or a Roth conversion) aren’t LCEs.
How to complete SSA-44 (step-by-step)
Step 1: Identify the life-changing event
Check the correct box and enter the date the event happened (e.g., retirement month/year).
Step 2: Estimate this year’s income
Enter the current tax year, then estimate your AGI and add tax-exempt interest (that’s your MAGI for IRMAA). Choose the correct filing status (this matters if you married/divorced or a spouse passed away).
Step 3: (Optional but smart) Estimate next year
If next year will be your first full year at the new, lower income (e.g., first full year retired), put that estimate here so SSA can set next year appropriately.
Step 4: Attach documentation
Provide simple proof (see next section), sign, and submit.
What to attach (keep it simple)
Always include two things:
- Proof of the life-changing event, for example:
- Retirement/work reduction: employer letter or pay stubs
- Marriage/divorce/death: certificate/decree/death certificate
- Loss of property (not at your direction): adjuster/government letter, police/fire report
- Pension loss: plan/administrator letter
- Employer settlement: settlement/attorney/employer letter
- Your income math for the year(s) in question:
- A one-page spreadsheet or PDF showing AGI and tax-exempt interest that add up to your MAGI (use my template below).
Helpful tool:
- IRMAA MAGI Estimator (Google Sheets) — fill in your year-to-date actuals and expected remainder; it calculates AGI and MAGI for SSA-44.
- Link for readers: Use the template →
How to submit
- Best: Upload to your my Social Security account (fast, instant confirmation).
- Or: Mail/fax or bring it to your local SSA office.
When your tax return for that year is filed, SSA may ask for the signed return or IRS transcript. They verify estimates and will refund/credit or bill any difference.
After you file: what to expect
- Timeline: Processing can take weeks to a few months.
- Decision letter: You’ll receive a new initial determination by mail. If approved, your IRMAA is adjusted and any overpayments are refunded or credited for the months covered.
- Annual reset: IRMAA is recalculated every year using IRS data from two years prior. If your income stays low and IRS data hasn’t caught up, you can file SSA-44 again with updated estimates.
Examples (to make this real)
- Retired mid-2025; IRMAA based on 2023: File SSA-44 now with 2025 estimate (Step 2) and, if 2026 will be your first full low-income year, add a 2026 estimate (Step 3).
- Sold a rental by choice in 2023; high capital gain: That’s not an LCE. You’ll generally pay IRMAA for the affected year, and it should drop when SSA uses a later tax year that reflects your lower income.
- Rental destroyed by fire in 2025; income now lower: That is an LCE (loss not at your direction). File SSA-44 with adjuster/government docs + your MAGI estimate.
FAQs
Will I get a heads-up if IRMAA will apply next year?
Usually yes. Social Security sends a determination notice (often late fall) showing what they’ll charge.
Is there a deadline tied to the life-changing event?
File as soon as the event causes a real income drop. The earlier in the premium year you file, the more months can be adjusted.
How long does it take to process?
Varies—often weeks to a few months. Uploading online avoids mail delays.
How far back do refunds go if I’m approved?
They refund/credit excess IRMAA for the months the new decision covers.
Do I need to re-file every year?
IRMAA resets annually using the two-year lookback. If your income remains lower and IRS data hasn’t caught up, file again with updated estimates.
Resources
- Current IRMAA brackets (official SSA) – 2025 tables and Part D add-ons
- SSA-44 form (PDF) – “Medicare IRMAA Life-Changing Event”
- Upload your request (my Social Security) – online submission portal
- SSA-561 (Reconsideration) – if there’s no LCE but the decision is wrong
- IRMAA MAGI Estimator (Google Sheets) – Make a copy