What IRMAA Is and How It Affects Your Medicare Costs

IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B (doctor visits) and Part D (prescription drugs) premiums if your income is above a certain threshold. The higher your income, the higher your IRMAA charge — it can add $70 to $560 per month to your Part B premium alone, depending on your income level and the year.

Medicare uses your tax return from two years ago to calculate IRMAA. For example, in 2025, Medicare looks at your 2023 tax return. This two-year delay means your IRMAA may not match your current income, which matters if you have recently retired, had a major life change, or experienced a significant drop in earnings.

IRMAA applies to people with higher incomes — the exact income threshold changes each year. In 2025, for example, single filers with modified adjusted gross income (MAGI) above $97,000 and married couples filing jointly above $194,000 begin paying IRMAA. If your income is below these amounts, you pay only the standard Medicare premium with no IRMAA charge.

Key Takeaways

  • IRMAA is an extra monthly charge on top of your regular Medicare Part B and Part D premiums based on your income from two years prior.
  • The income thresholds and IRMAA amounts change every year, so you should review your notice each January to see what you will pay.
  • If your income has dropped significantly due to retirement, job loss, or a major life event, you can request that Medicare recalculate your IRMAA using your current year's income.
  • IRMAA does not explore to Medicare Part A (hospital insurance) or to people with lower incomes, regardless of age.

How Medicare Calculates Your IRMAA Amount

Medicare uses your Modified Adjusted Gross Income (MAGI) from your federal tax return to determine IRMAA. MAGI is usually your adjusted gross income plus any tax-exempt interest you earned. Social Security benefits are not counted in MAGI, but investment income, pensions, and wages all are.

Medicare divides income into brackets, and each bracket has its own IRMAA charge. The higher your income, the higher the bracket you fall into and the more you pay. In 2025, there are five income brackets for single filers and five for married couples filing jointly. Each bracket adds a different amount to your Part B and Part D premiums.

The income thresholds and dollar amounts change every year. Medicare announces the new amounts in the fall, and they take effect the following January. You will receive a notice called the Initial Enrollment Notice or an Annual Notice of Change that tells you your specific IRMAA amount for the coming year.

When IRMAA Applies and When It Does Not

IRMAA applies to Medicare Part B and Part D premiums only. It does not explore to Part A (hospital insurance), and it does not affect your deductibles or copayments. If you have a Medigap or Medicare Advantage plan, IRMAA still applies to your Part B premium, but the way it is charged may differ depending on your plan type.

IRMAA does not explore if your income is below the annual threshold for your filing status. For 2025, single filers with MAGI of $97,000 or less and married couples filing jointly with MAGI of $194,000 or less pay no IRMAA. If you are married but file taxes separately, the rules are stricter and IRMAA kicks in at much lower income levels.

You only pay IRMAA if you are enrolled in Medicare Part B or Part D. If you decline Part D and do not have creditable prescription drug coverage elsewhere, you may face a late enrollment penalty if you join later, but you will not pay IRMAA during the years you are not enrolled.

Life Changes That Let You Request a Recalculation

If your income has dropped significantly since the tax year Medicare used to calculate your IRMAA, you can request that Medicare recalculate using your current year's income. This is called a Life-Changing Event request. Common events that may have access to include retirement, job loss, death of a spouse, divorce, or a substantial reduction in income or assets.

To request a recalculation, you must contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visit your local Social Security office in person. You will need to provide documentation of the life-changing event — for example, a termination letter from your employer, a divorce decree, or a death certificate. Social Security will review your request and, if approved, will recalculate your IRMAA based on your current income.

The recalculation is not automatic. You must initiate the request yourself, and it must be made within 60 days of the life-changing event. If you wait longer, Medicare may not honor the request, and you will continue paying the higher IRMAA amount until the next year's adjustment.

The Two-Year Lag and Why It Matters

Medicare always uses your tax return from two years ago. This delay can work in your favor or against you depending on your situation. If you retired last year and your income dropped, Medicare has not yet seen that drop — it is still using your higher pre-retirement income to calculate IRMAA. Conversely, if you had a large one-time gain two years ago, you may be paying IRMAA based on income you no longer have.

This two-year lag is why life-changing event requests exist. If you retired in 2024 and are now paying IRMAA based on your 2023 income, you can request a recalculation based on your 2024 income. However, you must do this within 60 days of your retirement date for Social Security to consider it a may have access to event.

Understanding the timing helps you plan. If you are approaching Medicare age and considering a major income change, knowing that Medicare will use your income from two years prior can help you decide when to make that change.

IRMAA Amounts and Income Brackets for 2025

The IRMAA brackets and amounts change annually. For 2025, Medicare has set five income brackets for both single filers and married couples filing jointly. Each bracket corresponds to a specific additional monthly charge for Part B and Part D.

Your notice from Social Security or Medicare will show exactly which bracket you fall into and what your total monthly premium will be. If you do not receive a notice, contact Social Security to request one. Do not assume your IRMAA amount stayed the same as the previous year — the thresholds and charges shift every January.

If you believe the income figure Medicare used is incorrect, you can request a correction. Contact Social Security with documentation of your actual income for the year in question. Errors do happen, and correcting them can lower your IRMAA charge.

What to Do If You Disagree With Your IRMAA Charge

If you receive a notice showing an IRMAA charge you believe is wrong, you have the right to appeal. First, check that the income figure on the notice matches your actual tax return. If it does not, contact Social Security with a copy of your tax return to request a correction.

If the income figure is correct but you believe a life-changing event qualifies you for a recalculation, submit your request to Social Security within 60 days of the event. Include documentation such as a job termination letter, divorce papers, or proof of a substantial loss of income or assets.

If you disagree with Social Security's decision on your appeal, you can request a hearing before an administrative law judge. This process takes time, but it is available to you at no cost. Contact Social Security for details on how to request a hearing.

Frequently Asked Questions

Does Social Security count toward my IRMAA income?

No. Social Security benefits are not included in the Modified Adjusted Gross Income (MAGI) that Medicare uses to calculate IRMAA. However, investment income, pensions, wages, and other sources of income do count. This is one reason why some people with substantial Social Security income but little other income may not pay IRMAA.

What happens if my income drops after I turn 65?

Medicare will continue using your income from two years ago until you request a life-changing event recalculation. If you retired or experienced a major income drop, contact Social Security within 60 days with documentation. They will recalculate your IRMAA based on your current income, which may lower your monthly premium.

Can I avoid IRMAA by delaying Medicare enrollment?

Delaying Part B enrollment may allow you to avoid IRMAA for a time, but you will face a late enrollment penalty if you enroll later. Part D has a similar penalty. For most people, the penalty over time costs more than the IRMAA would have. Speak with a Social Security representative about your specific situation before declining coverage.

Does IRMAA explore if I have a Medicare Advantage plan?

Yes. IRMAA applies to your Part B premium regardless of whether you have Original Medicare or a Medicare Advantage plan. The way the charge appears on your bill may differ, but you will still pay it. IRMAA does not explore to Part A, and it does not affect your plan's deductibles or copayments.

What if I am married but file taxes separately?

If you file separately, IRMAA thresholds are much lower — currently around $97,000 for married filing separately filers. This can result in a much higher IRMAA charge. If possible, filing jointly with your spouse may result in a lower overall IRMAA cost. Discuss this with a tax professional or Social Security representative.