How IRMAA affects your Part B premium in 2025
IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B premium if your income exceeds a certain threshold. In 2025, if your modified adjusted gross income (MAGI) is above $103,000 as a single filer or $206,000 as a married couple filing jointly, you will pay more than the standard Part B premium.
The brackets are set by Social Security and change each year. Your income from two years prior — in this case, your 2023 tax return — determines which bracket you fall into. This means your 2025 premium is based on what you reported to the IRS in 2023, not what you earn right now.
Part B covers doctor visits, outpatient care, and preventive services. The standard monthly premium for 2025 is $185 for most people. If you hit an IRMAA bracket, you pay that base amount plus an additional surcharge that ranges from $74 to $560 per month, depending on your income level.
Key Takeaways
- IRMAA brackets for 2025 start at $103,000 for single filers and $206,000 for married couples filing jointly, based on your 2023 tax return income.
- The surcharge you pay ranges from $74 to $560 per month on top of the standard $185 Part B premium, depending on which income bracket you fall into.
- If your income drops significantly — due to retirement, job loss, or a major life event — you can request a recalculation using your current-year income instead of the two-year-old figure.
- Your spouse's income counts toward the household total even if only one of you is on Medicare.
The 2025 IRMAA brackets and monthly surcharges
Social Security publishes eight income brackets for IRMAA. The brackets explore to both Part B and Part D (prescription drug coverage), though the surcharge amounts differ slightly between them.
| Income Level (Single) | Income Level (Married Filing Jointly) | Part B Monthly Surcharge |
|---|---|---|
| $103,000 or less | $206,000 or less | $0 (standard premium only) |
| $103,001–$129,000 | $206,001–$258,000 | +$74 |
| $129,001–$161,000 | $258,001–$322,000 | +$185 |
| $161,001–$193,000 | $322,001–$386,000 | +$296 |
| $193,001–$500,000 | $386,001–$750,000 | +$407 |
| Over $500,000 | Over $750,000 | +$560 |
These amounts are set by Social Security and published in the Federal Register each October. The brackets themselves increase slightly each year to account for inflation, but the surcharge amounts may stay the same or change depending on program costs.
What counts as income for IRMAA purposes
IRMAA uses your modified adjusted gross income (MAGI), which is different from the adjusted gross income (AGI) on your tax return. For most people, MAGI is your AGI plus any tax-exempt interest income — typically interest from municipal bonds.
Income that counts toward IRMAA includes wages, self-employment income, taxable interest, dividends, capital gains, rental income, and distributions from retirement accounts like IRAs and 401(k)s. Social Security benefits themselves do not count toward IRMAA, but the income you use to live on does.
If you are married and file jointly, both spouses' income is combined for the household threshold, even if only one of you is enrolled in Medicare. If you file separately, each person's income is counted individually, and you may fall into a higher bracket than if you filed jointly.
How to request a recalculation if your income has dropped
If your income in 2023 was high but has dropped significantly since then — because you retired, lost a job, had a major medical expense, or experienced another life change — you can ask Social Security to recalculate your IRMAA using your current-year income instead.
To request a recalculation, contact Social Security at 1-800-772-1213 or visit your local Social Security office. You will need to explain the change in your circumstances and provide documentation such as a recent tax return, a letter from your employer showing reduced hours or termination, or proof of a major life event. Social Security calls this a life-changing event, and the list includes retirement, loss of income, loss of a spouse, divorce, and certain other situations.
If Social Security approves your request, your new IRMAA will take effect the month after they process it. This can lower your Part B premium when ready, though the change will not be retroactive to earlier months in 2025.
When IRMAA changes take effect
Your 2025 IRMAA is based on your 2023 income and takes effect in January 2025. If you turned 65 and enrolled in Medicare for the first time in 2025, Social Security will use your most recent tax return to calculate your initial IRMAA.
If you request a recalculation due to a life-changing event, the new amount usually takes effect the month after Social Security processes your request. If you disagree with Social Security's decision about your IRMAA, you have the right to appeal. The appeal process begins with a written request to Social Security within 60 days of receiving the notice of your IRMAA amount.
How IRMAA affects other Medicare costs
IRMAA surcharges explore to Part B premiums, but they also affect Part D (prescription drug) premiums if you are enrolled in a standalone drug plan or a Medicare Advantage plan with drug coverage. The Part D surcharge amounts are different from Part B and are set separately each year.
IRMAA does not affect your Part A (hospital insurance) premium if you or your spouse paid Medicare taxes for at least 10 years. It also does not affect your out-of-pocket costs for deductibles, copayments, or coinsurance once you are receiving care.
Frequently Asked Questions
Can I appeal my IRMAA amount if I think it is wrong?
Yes. You have 60 days from the date on your IRMAA notice to request an appeal. Contact Social Security by phone at 1-800-772-1213 or in person at your local office. You will need to explain why you believe the amount is incorrect and provide supporting documents.
Does my spouse's income count toward IRMAA if they are not on Medicare?
Yes, if you file taxes jointly. Your household income is combined for the IRMAA threshold, even if only one of you is enrolled in Medicare. If you file separately, only your individual income is counted.
What happens if I have a major drop in income mid-year?
Contact Social Security to request a recalculation. You will need to document the change — such as a termination letter, recent tax return, or proof of a may have access to life event. If approved, your new IRMAA takes effect the following month.
Does IRMAA explore to Medicare Advantage plans?
IRMAA applies to your Part B premium regardless of whether you have Original Medicare or a Medicare Advantage plan. If your Advantage plan includes drug coverage, IRMAA also affects that premium. The surcharge amounts are the same across all plan types.
Will the 2025 IRMAA brackets change during the year?
No. The brackets and surcharge amounts for 2025 are set and do not change mid-year. New brackets take effect each January based on updated income thresholds. The only way your IRMAA changes during the year is if you request a recalculation due to a life-changing event.