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IRMAA: What is IRMAA in Medicare?

If you are a Medicare beneficiary with a high annual income, it may be a shock to realize your Medicare Part B and Medicare Part D premiums are higher than you initially thought they would be. This difference in premium reflects your Income Related Monthly Adjustment Amount (IRMAA).  

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The Social Security Administration determines if you owe an IRMAA based on the income you reported on your IRS tax return two years prior. If you feel your higher Medicare Part B premium is incorrect, there are steps you can take to appeal the IRMAA determination. 

What is IRMAA?

IRMAA is the Income Related Monthly Adjustment Amount added to your Medicare Part B and Medicare Part D premiums. You will only need to pay an IRMAA if your annual modified adjusted gross income (MAGI) exceeds a predetermined amount. 

In 2003, IRMAA was added as a provision to the Medicare Modernization Act. The provision was set to help increase the financial stability of Medicare for future beneficiaries. Rather than paying the standard premium, those who qualify for IRMAA must pay a higher monthly premium based on their income bracket. 

Most Medicare enrollees have Social Security automatically deduct their Medicare Part D and Medicare Part B premium from their Social Security check before it is deposited into their bank account each month. If you are not receiving income benefits with Social Security, you will typically receive a quarterly bill from Medicare. Regardless of how you pay your Medicare premiums, you will pay your IRMAA in addition to your premium each month. 

Can IRMAA Impact My Medicare Part B Premium?

Your income and tax-filing status from two years ago determine your IRMAA eligibility. If your income exceeds a pre-determined amount, IRMAA can impact your Medicare Part B premium. Keep in mind, each year the IRMAA amounts change. Thus, qualifying for IRMAA any year does not qualify you for life. 

Depending on your income, you may not have to pay the additional fee each year. Also, if you have a special situation and believe IRMAA should not apply to you, you can request a redetermination or IRMAA appeal.

How to Calculate IRMAA

To calculate your IRMAA, you will need to review your tax returns submitted to the IRS two years prior to the current year. Your IRMAA is based on the modified adjusted gross income stated on your tax form. 

Refer to the 2024 Medicare IRMAA Chart below for an idea of what Medicare costs you should expect in 2024.

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2022 Annual Income: Individual 2022 Annual Income: Filing Jointly 2022 Annual Income: Filing Separately Medicare Part B Premium 2024 Medicare Part D Premium 2024
$0 – $103,000 $0 – $206,000 $0 – $103,000 $174.70 Plan Premium
$103,001 – $129,000 $206,001 – $258,000 $244.0 Plan Premium + $12.90
$129,001 – $161,000 $258,001 – $322,000 $349.40 Plan Premium + $33.30
$161,001 – $193,000 $322,001 – $386,000 $454.20 Plan Premium + $53.80
$193,001 – $500,000 $386,001 – $750,000 $103,001 – $397,000 $559.00 Plan Premium + $74.20
> $500,000 + $750,000 + $397,000 + $594.00 Plan Premium + $81.00

2023 Medicare IRMAA Chart

2021 Annual Income: Individual 2021 Annual Income: Filing Jointly 2021 Annual Income: Filing Separately Medicare Part B Premium 2023 Medicare Part D Premium 2023
$0 – $97,000 $0 – $194,000 $0 – $97,000 $164.90 Plan Premium
$97,001 – $123,000 $194,001 – $246,000 $230.80 Plan Premium + $12.20
$123,001 – $153,000 $246,001 – $306,000 $329.70 Plan Premium + $31.50
$153,001 – $183,000 $306,001 – $366,000 $428.60 Plan Premium + $50.70
$183,001 – $499,999 $366,001 – $749,999 $97,001- $403,000 $527.50 Plan Premium + $70.00
> $500,000 + $750,000 + $403,001 + $560.50 Plan Premium + $76.40

You can also view the image below for more details on Medicare Part B income-related premiums.

Medicare Income-Related Monthly Adjustment Amount

What Line is MAGI on 1040?

Your modified adjusted gross income amount (MAGI) is made up of your total adjusted gross income plus any tax-deducted income. If you are unsure of your MAGI, you can quickly figure it out by looking at your tax return records. On your IRS Form 1040, these are line items 37 and 8b.

If the SSA determines that you owe a higher Medicare Part B premium based on your MAGI, they will notify you of your new amount by mail. However, if you think the income information Social Security used to determine your Income Related Monthly Adjustment Amount was incorrect or outdated, you can request an appeal for Medicare to revisit the decision.

In this case, you may need to contact the IRS and correct any wrong information before you file the appeal. Fixing the issue may be as simple as filing an amended tax return.

A new initial determination is a revised decision that the SSA makes regarding your Income Related Monthly Adjustment Amount. If you have experienced a life-changing event that caused a decrease in income, you can request that the SSA revisit its decision.

Situations Social Security Considers Life-Changing Events:

  • Marriage
  • Divorce
  • Spousal death
  • You or your spouse stop working or reduce the number of working hours
  • Involuntary loss of income-producing property due to a natural disaster, disease, fraud, or other circumstances
  • Receipt of the settlement payment from a current or former employer due to the employer’s closure or bankruptcy

You can request a new initial determination by submitting a Medicare IRMAA Life-Changing Event form. You can also schedule an appointment with Social Security. Documentation will be required with proof of the life-changing event that caused your income to go down.

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How to Appeal the IRMAA Decision

If requesting a new initial determination is not an option, you have the right to file an appeal for your Medicare Part B premium increase.

Social Security does not have a strict timeframe in which they must respond to a reconsideration request. If you have questions about your appeal status, it is best to contact the agency currently reviewing your appeal.

An appeal will not cost you anything, and if you state your case well enough, you may save yourself some money.

If you want to appeal your IRMAA, you should visit the Social Security website and complete the Request for Reconsideration form. The form will give you three options on how to appeal, with the easiest and most common way being a case review.

Documentation is essential for an appeal. You should write a cover letter explaining why you believe you are being overcharged and provide backup documentation.

You can appeal your Medicare Part B premium increase for outdated or incorrect information when you:

  • Filed an amended tax return with the IRS
  • Have a more recent tax return that shows you are receiving a lower income than previously reported

For example, let’s say you were single with an income of $105,000 the year you retired. Then, two years later, your income is only $45,000 from Social Security and IRA distributions. If this is the case, then you should not have to pay a higher Medicare Part B premium based on your former income.

Documentation Needed to File an IRMAA Appeal

  • A letter from your former employer confirming your retirement
  • A copy of your last pay stub to show your decreased income
  • Any official documents that support your case

If you have a successful appeal, Social Security will automatically correct your Medicare Part B premium amount. If you’re denied, they will provide instructions on how to appeal the denial to an Administrative Law Judge. While you are in the process of the appeal, you will continue to pay the higher Medicare Part B premium.

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FAQs

What are the MAGI limits for Medicare premiums?
The MAGI limits for Medicare premiums change every year and are different for those who file jointly and separately.
How can I avoid IRMAA?
You can lower your MAGI in a few ways, including contributions to a pre-tax retirement plan or HSA account, and through health insurance premiums you pay while self-employed. Also, consider deductions on your tax return.
How do I dispute IRMAA?
If your income has seen a significant decrease in the past two years, you can file an appeal. To dispute your IRMAA payments, complete Form SSA-44 with information about your life-changing event and income reduction.
Is there a refund after a successful IRMAA appeal?
Yes, the IRS will refund any excess amounts.
How much money can you have in the bank on Medicare?
There is no asset or income limit that disqualifies otherwise eligible people from Medicare. Yet, there is a cap on IRMAA that is subject to increase annually.

Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare guru serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Medicare Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

56 thoughts on "IRMAA: What is IRMAA in Medicare?"

  1. I received an IRMMA for my 2022 premiums, based on 2019 Fed Tax Return. I knew that I needed to wait until my 2021 Fed Tax Return was completed to reflect a change in income in 2021 due to life changing event: retirement, to appeal the IRMMA determination. I filed appeal in July 2022 and was immediately successful in a determination that my premiums should not be subject to IRMMA, and have statement showing all months of 2022 should be at base Medicare B premium as well as Part D. I have paid the extra IRMMA fees for January 2022 through August 2022. September 2022 does reflect the new correct premium. How do I seek refund on the IRMMA fees for January through August 2022?

    1. Hi John! If your IRMAA repeal was successful and you overpaid for your premiums, you can receive a refund of the overage. Your refund will be processed through Social Security. So, I recommend contacting your local office and speaking with them about the refund process as each location will handle this differently.

  2. I am having an issue with my Medicare Billing and have talked to them several times regarding my IRMAA.
    the gentleman at Social Security told me that when I receive a determination from them that the amount listed on the chart is the amount in excess of what the Medicare Insurance Premium which is not what is stated in the letter.
    For Example the Determination is that the premium is 237.60 PartB IRMAA and that I need to add 170.10 to that for the actual premium, so my total premium for B is 407.70.
    I told him that that does not make sense as I have never been bill this way for just the Part B that the premium bill is 237.60.
    I have requested an audit of my account but they are billing me 2500, and I have paid the IRMAA billed each month.
    Can you possibly give me some insight.

    1. Georgina, This does seem like a complex situation. Typically, your IRMAA amount is not in addition to the Part B premium ($170.10) but it replaces that amount. So, to my knowledge, your premium should be $237.60 if that is your IRMAA determination.

  3. How is IRMA determined when filing 1040 married jointly? My income has gone down substantially as I’m not working much(I’m freelance) but my husband’s has not. Is my IRMA based on both our incomes together, or just mine? And line 37 of 1040 looks to me like that is”amount owed. I’m confused. Thank you.
    “.

    1. Jean, if you are filing jointly, your decrease in income will affect both you and your husband. If you feel your decrease in income warrants an IRMAA appeal, you can do so by contacting your local SSA.

  4. Hi Jagger,
    I recently filed a SSA-44 and dropped it off at my local SSA office. Where can I see the tracking on my appeal? There is no area that shows an appeal on my Social Security Overview. Under what heading should it appear?

    1. Bill, unfortunately it seems that the tracking is unavailable through the Social Security website at this time. To track your claim I recommend calling your local SSA for an update.

  5. We over paid IRMAA in 2020 and 2021 due to an income decrease. I contacted SSA and they tell me I cannot ask for a refund from previous years. Is this correct? Are there any suggestions?

    1. Thank you for reaching out, Mitch. Unfortunately, you are not able to receive IRMAA refunds for previous years due to a now lower income. The amount you paid previously was based on tax returns from two years prior.

  6. My spouse inherited about $150,000 in 2020 following her brother’s death in 2018 which caused our income to rise above the IIRMA limit. Our combined income for 2021 will be around $80,000. I would like to have SSA reconsider my IIRMA penalty. Do I have a case and if I do, where do I send any documentation I have? I see forms on ssa.gov but nowhere can I find how or where to submit them. Thanks, Dan.

    1. Dan, a change in income status is always a case for an appeal. The most direct way to do so is to contact your local Social Security office and explain your situation. From there, they will direct you on how to file the appeal.

  7. I retired in 2021 and recently received my initial determination letter indicating an 2022 IRMA amount based on my 2019 tax return. Since I’m retired, I’m sure my 2021 MAGI will be less than my MAGI in 2019 or 2020. Do I need to file an appeal now within the 10 days indicated in the letter or can I wait until I file my 2021 tax return and then file an appeal?

    1. Bob, I would file the appeal as soon as possible. It would be better to file too early and have to file again than to be too late.

  8. Jagger – I filed online for non-medical IRMAA appeal (reconsideration) for 2022 based on 2020 Tax year info on 1040-SR. Because of an error on my 1040-SR, I filed 1040-X which was accepted & corrected. It was completed by IRS in mid-Nov. I filed the IRMAA appeal Nov 29 and received auto-email confirming receipt.
    Questions: (1) What is approximate time for an answer? (2) How will I be notified? (3) Is there a place online to check on progress, similar to IRS webpage to check progress on amended returns?
    The appeal process gave no answers to these questions. There is no message on “my Social Security” login relating to the appeal.
    Thanks for your help.

    1. if you get an answer let me know, I’m in a similiar boat and was wondering when I would hear something back and/or how to check the status

      1. Greg – My question (12-9-21) has not been answered yet even though a later one (12-21-21 from Bob) has been answered (1-10-22 by Jagger). Try asking your question independently and see if we get an answer. Feel free to refer to my question. The place to do this is at the bottom of this page titled COMMENT. After posting and approved, it will then appear at top of these Questions (Comments). Let’s hope he sees it. I’ll keep checking. – Rich

      2. Hi Greg & Rich, we apologize for the delay in our response, as comment volume for the site was especially high around the Annual Enrollment Period. However, you should be able to view your appeal status through your Social Security login. If you are not seeing any trace of the appeal, I recommend calling Social Security to attempt to resolve the issue. Appeals can take 2-4 weeks to fully process. If this time has passed, I would reach out via telephone or go to your local SSA office.

  9. Jagger, you give this example: For example, say you were single with an income of $95,000 the year you retired [let’s call this year 1]. Then, two years later [year 3] your income is only $45,000 from Social Security and IRA distributions. If this is the case, then you should not have to pay a higher Part B premium [in year 3] based on your former income [in year 1]. Let’s further assume that income in the year after retirement [year 2] is $91,000 (due to payment of year 1 bonus in year 2).

    An appeal due to a life-changing event is filed. Does Social Security admin have flexibility to choose whether to base year 3 IRMAA on either year 2 or year 3 income? Or are there clear rules and procedures that must be applied?

      1. Always? Then why did my wife’s 2022 initial irmaa determination state it used the 2019 tax return filing for determination?

      2. Hi Chris, your wife has not filed her 2021 taxes yet, so the determination is two tax returns ago at the time it is made.

  10. I have Medicare Part D IRMAA deductions taken from my social security. I did not sign up for Part D. I pay for drug coverage through WellCare. Should I be charged for Part D IRMAA?

    1. Hi Kathleen – it sounds like you have a Part D prescription drug plan through WellCare. Your IRMAA will be charged on top of your Part D as well as your Part B.

  11. I retired early in 2021 and will be 65 in March 2022. I understand that if elect to sign up for Part B without penalty I need to do so between January and June 2022. I am fortunate to have a FEHB but my IRMMA for 2020 would require an additional $340 for Part B. Is it possible to obtain a IRMMA determination form SSA before signing up and being obligated to paying the IRMMA? I’d like to know this to decide whether or not to sign up or to take the penalty for delaying a year or two which may cost me less in the long run. Thanks

    1. Dennis, you can always appeal your IRMMA determination if you believe your circumstances warrant a change. To create an appeal, you can contact your local SSA office for more details.

  12. This week my husband and I both received IRMAA letters saying our adjusted gross income for 2020 will increase our Medicare premiums for 2022. Normally we make under $100,000/year filing jointly but a sale of investment property threw us into a much higher bracket. This was a one time event and our income went back to normal in 2021. The letter we got says the information is for one year only. Does that mean when SS gets our 2021 tax return and sees the lower adjusted gross income amount they will automatically reduce our payments? Or do we have to do something within the 60 days of receiving the letter?

    1. Hi Deborah – you can appeal the IRMAA by showing your reduced income for this past year to the IRS. Any excess amounts you have paid before this is processed would be refunded to you.

    1. Hi Doug – you will need to pay an IRMAA if your MAGI from your tax return two years prior requires, regardless of your age.

  13. I was laid off in January 2021 and am now retired. I was provided final bonus payments in 2021 and also a 12 month severance (paid monthly) that will end in January 2022. While my spouse will continue to work, our jointly filed 2022 income will be less than the lowest 2022 IRMAA adjustment threshold. I plan to appeal the adjustment for 2022 but am unclear for the Form SSA-44 what Tax Year to indicate for Steps 2 and 3. Also since my last severance payment will be in January 2022 and I expect to get the IRMAA notice in late November 2021, when would I need to file the appeal timely?

    1. Hi David – the IRMAA for your Part B premium is based upon your MAGI two years prior. Thus, the tax forms you should use to determine what you pay for 2022 would be from 2020. For Step 2, you should include the year you had a life-changing event that reduced your income, which would be 2021. For Step 3, you estimate your income for next year (2022) if you think you will be making less.

    2. David: I retired in November of 2020. My income for 2021 is very low as compared to 2020. Since I have not yet filed my taxes for 2021, what proof can I supply when filing the appeal to reduce my 2022 IRMAA?

      1. Bernie – you can supply a recent tax return to appeal to reduce your IRMAA for the coming year.

  14. Lindsay,
    If my Roth conversions in the 2 years prior to Medicare would cause surcharges, but I stopped the conversions the tax year of applying for Medicare, would that be an appealable event ? Voluntary reduction of income does not seem to be a legit consideration under their list of life changing events.

      1. Have you seen this in action? The rule makes it seem like if do large Roth Conversions the two years before 65 it will affect IRMAA charges. If income is reduced the year you turn 65 below the threshold have you seen an appeal have success? I’d love to know more about this issue as I help clients with Roth Conversions and this is a big issue.

        Thanks

        Brian

      2. Hi Brian – we will leave your comment on this page so anyone who has filed an appeal can let you know about their experience.

  15. I retired effective 9/1/21 and am appealing my IRMAA based on projected MAGA 2021. If my projections are wrong, I assume I will have to “true up” the premiums by paying the shortfall. Is this correct? If so: (1) is there a penalty? (2) Do I contact the SSA proactively or will they contact me? Thanks!

    1. Hi Bill! When you become eligible for Medicare, SS will use your tax return from two years prior to determine your premium amount. If SS determines you owe a higher premium based on your MAGI, you will be notified of the additional amount. This notice is called initial determination. At that time, if you think the amount is incorrect, you can request them to revisit this decision. This option will be included in your initial determination documentation. If for any reason you cannot request them to revisit your initial determination, you can then appeal the decision using Form SSA-44. If SS rules in our favor, your premium will be adjusted accordingly. If they determine you overpaid based on the information you provided, then you will be refunded that amount. (1) I have not come across this situation, to be honest. However, I imagine that it could be very possible they will penalize you. (2) SSA will contact you regarding the premium determination via mail.

  16. I retired in 2018, but continued to receive some deferred bonus payments from my employer through 2019. Because of that I ended up overestimating my income for 2019 and did not contest the IRMAA estimate for that year. But my actual income turned out to be much less, which means I overpaid IRMAA by some 2500$. I thought SSA was going to send me the refund automatically, and when that didn’t happen, I submitted, in December 2020, SSA-44 (with a copy of my 2019 IRS 1040 return) to get the refund, but I was told it’s too late to claim such refund. Is this correct? and if so, how should I appeal the decision? Thanks for your help.

    1. Hi Magda! You have 60 days to request a redetermination from the time you were notified of your IRMAA adjustment. Unfortunately, SSA is correct in saying that it’s too late to claim a refund.

  17. Is the IRMA charged for both husband and wife the same. Meaning if the husband is paying $372 per month for Part B now, when I turn 65 in December, if I start Medicare Part B I will have to pay $372 per month too?

    1. Hi BJ! If you file your taxes jointly then yes, the husband and wife will each have to pay the increased premium for Part B.

  18. On December 16, 2020,I submitted by mail an SSA-44 together with proof showing a work reduction that would substantially lower my income and the significant increase in my IRMAA. I have received nothing from Social Security about that request (not even an acknowledgment that they received it. I have just filed my tax return for 2020 showing the reduced income but am hesitant to send that until I hear something. Should I just continue to wait? When should I expect to hear something?

      1. I have an account and submitted an appeal on 12/20. Nothing on My account. No acknowledgement of the appeal.
        Is there another way to track the appeal

  19. I would like to know how that extra money they get thru I.R.M.A.A. is used. Does it help pay for Obamacare?

  20. Hello Lyndsey my husband has been unemployed since June of 2020. We have already sent in a SSA-44 with all our information. The appeal was granted now I have received another notice that in 2021 we again are both being charged again for IRMAA. Please advise how I can handle this. Thank you for your time

    1. Hi Leah! Unfortunately, you would need to submit the SSA-44 again for 2021 since they are looking at your taxes from 2 years previous. They are still seeing your income from before your husband became unemployed. I hope this helps!

  21. I received a $6600 federal energy tax credit. That credit threw me $1200 over into an IRMA. Is there consideration to remove that tax credit in calculating my IRMA? I would like to appeal the IRMA. Hopefully we are not penalized for going green. Thank you, Cindy

    1. Hi Cynthia! I would imagine this qualifies for an appeal due to a change in circumstance. Assuming the credit is only applied to one year of your tax returns. It doesn’t hurt to try!

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