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IRMAA (Income-Related Monthly Adjustment Amount)

For those with an income above a certain amount, they may be required to pay an Income-Related Monthly Adjustment Amount (IRMAA) in addition to their Part B premium and Part D premium. 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 you’re higher Part B premium is incorrect, there are steps you can take to appeal IRMAA.

What is the Income-Related Monthly Adjustment Amount for Medicare (IRMAA)?

Most enrollees have their Part B premium taken out of their Social Security check before the beneficiary gets the deposit. If you are not earning income benefits with Social Security, you will typically receive a bill. Those in the highest income bracket can pay considerably more for their Medicare Part B costs. Social Security will determine what you pay based on your modified adjusted gross income (MAGI), as reported by the IRS.

A Request for Reconsideration is a petition you can file with the SSA to reduce your Part B premium. You should submit a Request for Reconsideration if there is a valid reason you believe you should not have to pay the higher premium.

Part B Premiums for High-Income Beneficiaries Who are Married Filing Jointly

Below are the premium brackets for those with a single and joint file income status.

Medicare Income-Related Monthly Adjustment Amount

Modified Adjusted Gross Income Amount (MAGI)

Your Modified Adjusted Gross Income amount is made up of your total adjusted gross income in addition to any tax-exempt interest income. On your IRS Form 1040, these are line items 37 and 8b; if you are unsure of your MAGI, you can quickly figure it out by looking at your tax return records. Income examples that you may have reported on your tax return would include wages, dividends, alimony received, rental income, investment income, capital gains, farm income, and SSA benefits.

Deduction examples that you may have taken on your tax return would be things like alimony paid, tuition, student loan interest, and retirement plan contributions.

If the SSA determines that you owe a higher premium based on your MAGI, they will notify you of your new amount by mail. This notice is called an initial determination, and the notice should include information on how to request a new initial decision.

If you think the income information Social Security used to determine your Income-Related Monthly Adjustment Amount was incorrect or outdated, you can also request them to revisit the decision.

If this is the case, you may need to contact the IRS and correct that 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.

If you do not know why you are paying an IRMAA, you can call the Social Security hotline.

Situations where Social Security Considers Being Life-Changing Events

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

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

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 either your correct income or of the life-changing event that caused your income to go down.

When you move into retirement, it’s common for you to stop working or work fewer hours. Retiring can impact your monthly income quite a bit and be must less than when you were working.

For example, say you were single with an income of $95,000 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 Part B premium based on your former income.

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. Requesting a reconsideration is also referred to as appealing an Income-Related Monthly Adjustment Amount decision.

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.

If you can demonstrate a change in your income, it does not hurt to try to file an 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 for the form called Request for Reconsideration. The form will give you three options on how to appeal, with the easiest and most common way being a case review.

Documentation is an essential thing in any appeal. You should write a cover letter explaining how you think you’re being overcharged. Then you will need to provide backup documentation.

What Documentation Do I Need to Appeal IRMAA

  • 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.


Can IRMAA Impact my Part D Premium?
The Income-Related Monthly Adjustment Amount also affects your Part D premium. You will pay the premium for your chosen plan, and then the adjustment will be added to that premium. Your prescription drug insurance company will collect the amount on behalf of Social Security.
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 reduce my Medicare MAGI?
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 when you’re 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.
What income is counted for Medicare premiums?
Medicare premiums are calculated using your modified adjusted gross income (MAGI). This is your adjusted gross income (AGI), less deductions.
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.
Does everyone pay the same for Medicare?
The majority of beneficiaries pay the standard monthly premium. However, if your modified adjusted gross income exceeds a specific amount, you’re subject to pay an Income Related Monthly Adjustment Amount.

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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

18 thoughts on “IRMAA (Income-Related Monthly Adjustment Amount)

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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?

  6. 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?

  7. 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!

  8. 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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