How Medicare premiums change based on your income in 2025

Medicare uses your income to set what you pay for Part B (doctor visits) and Part D (prescription drugs). The higher your income, the higher your monthly premium — a system called Income-Related Monthly Adjustment Amounts, or IRMAA. In 2025, these brackets shift upward from 2024, but the income thresholds and premium amounts vary by filing status and change each year.

Medicare looks at your tax return from two years prior. So in 2025, Medicare uses your 2023 income to calculate your premiums. If your income was lower in 2023 than it is now, you can request that Medicare recalculate based on your current income — but you have to ask, and you need to show proof of the change.

Key Takeaways

  • Medicare uses your income from two years ago to set Part B and Part D premiums, so 2025 premiums are based on what you reported on your 2023 tax return.
  • Income brackets are different for single filers, married filing jointly, and married filing separately — and married filing separately usually results in the highest premiums.
  • If your income dropped since 2023 due to retirement, job loss, or divorce, you can file a Life-Changing Event form to ask Medicare to recalculate using current income.
  • Part B premiums in 2025 start at $174.70 per month for those below the income threshold, then increase in steps as income rises.
  • Part D premiums vary by plan, but the income-related surcharge ranges from about $7 to $76 per month depending on income level.

Part B premium brackets for 2025

Part B covers doctor visits, outpatient care, and some medical equipment. The standard Part B premium for 2025 is $174.70 per month if your income is below the threshold. Once your income crosses into a higher bracket, you pay the standard premium plus an additional amount called the IRMAA surcharge.

For single filers, the brackets in 2025 are:

  • $176,000 or less: $174.70 per month
  • $176,001 to $222,000: $244.90 per month
  • $222,001 to $268,000: $315.10 per month
  • $268,001 to $314,000: $385.30 per month
  • Over $314,000: $455.50 per month

For married filing jointly, the brackets are:

  • $352,000 or less: $174.70 per month
  • $352,001 to $444,000: $244.90 per month
  • $444,001 to $536,000: $315.10 per month
  • $536,001 to $628,000: $385.30 per month
  • Over $628,000: $455.50 per month

For married filing separately, the threshold is $176,000 — the same as single filers — which means couples filing separately almost always pay higher premiums than those filing jointly.

Part D premium brackets for 2025

Part D covers prescription drugs. Unlike Part B, which has a standard premium set by Medicare, Part D premiums vary by plan. However, all plans add an income-related surcharge on top of their base premium if your income is high enough.

The income brackets for Part D surcharges in 2025 follow the same thresholds as Part B. The surcharge itself ranges from roughly $7 to $76 per month depending on which income bracket you fall into, but the exact amount depends on your specific plan. When you review your plan options during open enrollment, the total premium shown includes both the plan's base premium and your income-related surcharge.

If you are in a Medicare Advantage plan that includes prescription drug coverage, the income-related surcharge is added to that plan's premium instead of being billed separately.

How Medicare calculates your income

Medicare uses Modified Adjusted Gross Income (MAGI) from your federal tax return. For most people, this is the same as your adjusted gross income. It includes wages, self-employment income, interest, dividends, rental income, and Social Security benefits — but not all of it. Only half of your Social Security benefits count toward MAGI for Medicare purposes.

The income figure Medicare uses is from your tax return filed two years before the year in question. So your 2025 premiums are based on your 2023 return. If you have not yet filed your 2023 return, Medicare will use an estimate or your 2022 return until the 2023 return is processed.

If you are married and file jointly, Medicare adds both spouses' incomes together. If you file separately, each person's income is counted individually — which is why married filing separately usually triggers higher premiums for both people.

What to do if your income changed since 2023

If your income in 2024 or 2025 is significantly lower than it was in 2023, you do not have to wait until next year's premium adjustment. You can request that Medicare recalculate your premiums based on your current income by filing a Life-Changing Event form (also called an appeal or reconsideration request).

Life-changing events that may have access to include retirement, job loss, death of a spouse, divorce, or a significant drop in income from investments. You will need to provide proof — a letter from your employer showing your end date, a divorce decree, a death certificate, or a recent tax return or pay stub showing lower income.

Contact Social Security at 1-800-772-1213 to request the form, or visit your local Social Security office. Processing usually takes four to six weeks. If approved, your new premium takes effect the month after Social Security processes the change.

How to find out your current premium

Your Part B premium appears on your Social Security benefit statement if you receive benefits. If you do not receive Social Security yet, Medicare sends a notice each year showing your premium amount and the income used to calculate it.

You can also log into your Medicare.gov account to see your Part B premium and view your income record. For Part D, log in to your plan's website or call the plan directly — the premium is not shown on your Medicare.gov account because it varies by plan.

If you disagree with the income Medicare used, you have the right to appeal. The notice you receive each year includes instructions for requesting a reconsideration. You have 60 days from the date on the notice to file.

Frequently Asked Questions

Does my spouse's income affect my Medicare premium if we file taxes separately?

No. If you file taxes separately, only your own income counts toward your premium calculation. However, married filing separately usually results in higher premiums for both people because the income threshold is lower than for married filing jointly.

What counts as income for Medicare premium purposes?

Medicare uses Modified Adjusted Gross Income from your tax return, which includes wages, self-employment income, interest, dividends, rental income, and half of your Social Security benefits. It does not include Supplemental Security Income (SSI) or certain other benefits.

Can I appeal my premium if I think the income is wrong?

Yes. If the income on your notice does not match your tax return, you can request a reconsideration within 60 days. Contact Social Security or Medicare with a copy of your tax return as proof. If the income is correct but has dropped since then, file a Life-Changing Event form instead.

When do the 2025 brackets take effect?

Part B and Part D premiums based on 2025 brackets take effect January 1, 2025. If you are already on Medicare, your new premium appears in your January benefit statement or notice. If you are enrolling for the first time, your premium is calculated when your coverage begins.

Do these brackets explore to Medicare Advantage plans?

Yes. If you have a Medicare Advantage plan, the same income brackets and surcharges explore to your plan premium. The surcharge is added to whatever your plan charges, so your total monthly cost may be higher than the base plan premium shown during enrollment.