When most people enroll in Medicare, they expect their monthly premiums to be straightforward and predictable. And for the majority of enrollees, that’s true. But if you’re among the roughly 10% of Medicare beneficiaries with a higher income, your premiums may come with an unexpected adjustment—one that can significantly increase your monthly costs. This adjustment is called IRMAA, short for Income-Related Monthly Adjustment Amount. And while it’s not a penalty, it can still come as a surprise if you’re not expecting it.
In this post, we’ll explain how IRMAA works, why it’s based on income from two years ago, and what you can do if your income has recently gone down.
What Is IRMAA?
IRMAA is an additional charge added to your Medicare Part B and Part D premiums if your income is above a certain threshold. It’s not a penalty—it’s Medicare’s way of requiring higher-income beneficiaries to contribute more toward the program.
These adjustments are calculated annually by the Social Security Administration using your Modified Adjusted Gross Income (MAGI) from two years ago.
So if you’re on Medicare in 2026, your IRMAA is based on your 2024 tax return.
2025 Part B Premiums: The IRMAA Breakdown
Most Medicare beneficiaries (about 90%) will pay the standard Part B premium of $202.90/month in 2026. But if your MAGI is above the thresholds below, you’ll owe more:
| Filing Status | 2023 MAGI (Modified Adjusted Gross Income) | 2025 Monthly Part B Premium |
| Single | $109,000 or less | $202.90 |
| Married Filing Jointly | $218,000 or less | $202.90 |
| Single | $109,001 – $137,000 | $284.10 |
| Married Filing Jointly | $218,001 – $274,000 | $284.10 |
| Single | $137,001 – $171,000 | $405.80 |
| Married Filing Jointly | $274,001 – $342,000 | $405.80 |
| Single | $171,001 – $205,000 | $527.50 |
| Married Filing Jointly | $342,001 – $410,000 | $527.50 |
| Single | $200,501 – $499,999 | $649.30 |
| Married Filing Jointly | $410,001 – $749,999 | $649.30 |
| Single | $500,000 and above | $689.90 |
| Married Filing Jointly | $750,000 and above | $689.90 |
And remember: these amounts are per person. If both you and your spouse are on Medicare and fall into a higher bracket, you’ll each pay the IRMAA amount.
How to Appeal IRMAA
If your income has dropped since the year they’re using to calculate IRMAA, you might be able to appeal.
You can request a reconsideration using Form SSA-44 if you’ve experienced one of the following qualifying life events:
- Retirement or reduced work hours
- Death of a spouse
- Divorce or annulment
- Loss of income-producing property
- Loss or reduction of pension income
- Employer settlement payment
- Marriage (if it lowers your household income)
You don’t have to eliminate IRMAA entirely for it to be worth appealing—even moving down one income tier can save you hundreds of dollars a year.
The Bottom Line
If you’ve been hit with an IRMAA, congratulations! That just means you’ve been very successful. This is basically the government’s way of saying, “Wow, you did well for yourself—and now we’d like a little more, thanks.”
But in all seriousness, we understand that as you age, your income may not be what it was two years ago. You might be retired, partially retired, or in a completely different season of life than when the IRS last checked your tax return. And yet, Medicare still looks backward—not at where you are now, but where you were then.
Understand Your Medicare Costs—And What You Can Do About Them
When it comes to Medicare, your income history can have a bigger impact than most people realize. But that doesn’t mean you’re stuck with a higher premium forever. If your situation has changed, you may have more control than you think.
Whether you’re trying to make sense of IRMAA, exploring your appeal options, or just looking for clarity around what’s next, we’re here to help.
Call (800) 864‑8890 or schedule your free consultation today. Our licensed Medicare Guides will walk you through the process, answer your questions, and help you take the next step with confidence.