Sanela
Medicare beneficiaries with higher Modified Adjusted Gross Income (MAGI) can face sizable premium surcharges called IRMAA (Income-Related Monthly Adjustment Amount) on Part B (medical insurance) and Part D (prescription drug coverage).
Understanding the 2-year income look-back, what counts as MAGI, and how to appeal with Form SSA-44 can save hundreds—sometimes thousands—of dollars a year.
Quick refresher: What IRMAA is (and isn’t)
- IRMAA is an extra monthly charge added to your normal Part B and/or Part D premium when your MAGI from two years prior is above set thresholds. For 2025, SSA generally looks at 2023 tax data.
- MAGI for IRMAA = AGI (Form 1040, line 11) + tax-exempt interest (line 2a) (for example, municipal bond interest). It’s simple—but it does capture many common retirement-income spikes (RMDs, Roth conversions, capital gains, large IRA withdrawals).
- If you’re assessed IRMAA for both Part B and Part D, you’ll pay both adjustments; if you only have one of those benefits, you’ll only pay the IRMAA for that part.
2025 IRMAA thresholds and amounts (current year)
Standard Medicare Part B premium in 2025 is $185/month. IRMAA begins if your 2023 MAGI exceeded $106,000 (single) or $212,000 (married filing jointly). (Married filing separately rules differ; see note below.)
Part B (medical) – 2025 monthly totals (standard premium + IRMAA)
| 2023 MAGI | Filing status | Total Part B premium |
|---|---|---|
| ≤ $106,000 | Single | $185 |
| $106,001 – $133,000 | Single | $259 |
| $133,001 – $167,000 | Single | $370 |
| $167,001 – $200,000 | Single | $480.90 |
| $200,001 – $499,999 | Single | $591.90 |
| ≥ $500,000 | Single | $628.90 |
| ≤ $212,000 | Married filing jointly | $185 |
| $212,001 – $266,000 | MFJ | $259 |
| $266,001 – $334,000 | MFJ | $370 |
| $334,001 – $400,000 | MFJ | $480.90 |
| $400,001 – $749,999 | MFJ | $591.90 |
| ≥ $750,000 | MFJ | $628.90 |
These totals come from SSA’s 2025 premium schedule (they already include the IRMAA add-on).
Part D (prescription) – 2025 IRMAA add-on (paid to Medicare)
Your Part D base premium varies by plan. If you’re subject to IRMAA, this extra amount is added on top of your plan’s premium:
| 2023 MAGI | Filing status | Part D IRMAA (add-on) |
|---|---|---|
| ≤ $106,000 | Single | $0 |
| $106,001 – $133,000 | Single | $13.70 |
| $133,001 – $167,000 | Single | $35.30 |
| $167,001 – $200,000 | Single | $57.00 |
| $200,001 – $499,999 | Single | $78.60 |
| ≥ $500,000 | Single | $85.80 |
| ≤ $212,000 | MFJ | $0 |
| $212,001 – $266,000 | MFJ | $13.70 |
| $266,001 – $334,000 | MFJ | $35.30 |
| $334,001 – $400,000 | MFJ | $57.00 |
| $400,001 – $749,999 | MFJ | $78.60 |
| ≥ $750,000 | MFJ | $85.80 |
(Part D IRMAA is tied to the national base beneficiary premium and changes yearly.)
Married filing separately (MFS): If you lived with your spouse at any time during the year and file MFS, the thresholds are stricter: $106,001–$149,000 → Part B = $259; Part D IRMAA = $13.70; ≥ $149,001 → Part B = $628.90; Part D IRMAA = $85.80. At $106,000 or less, you pay standard Part B ($185) and no Part D IRMAA.
What actually triggers IRMAA?
- Income from two years ago: 2025 IRMAA is based on 2023 MAGI that IRS reports to SSA. If SSA can’t get 2023, it may use 2022.
- MAGI composition: wage income, RMDs, IRA/401(k) withdrawals, Roth conversions, capital gains, dividends/interest, business income plus any tax-exempt interest (e.g., muni bonds).
- Filing status: Single vs. MFJ vs. MFS put you into different brackets.
How and when you’ll be notified
SSA sends an IRMAA determination notice when your new year’s premiums are set (commonly late fall for the following January). If you disagree, you can appeal.
Appealing an IRMAA determination: two pathways
You have two main routes:
- Request a “new initial determination” using Form SSA-44 if you had a qualifying life-changing event (LCE) that reduced your income after the tax year SSA used (for example, you retired in 2024 but SSA is using your higher 2023 income). You can upload the request online or file through your local office.
Qualifying LCEs include: marriage, divorce/annulment, death of a spouse, work stoppage or reduction, loss of income-producing property, employer pension plan termination/receipt reduction, or receipt of a settlement from an employer. (Bring documentation such as separation/retirement letters, pension statements, divorce decrees, or a spouse’s death certificate.)
- File a reconsideration appeal (SSA-561) if you believe SSA miscalculated or used wrong tax data (for example, IRS processed your amended return). In general, you must appeal within 60 days of receiving the notice (SSA presumes receipt 5 days after the notice date). You can appeal online, by mail, or in person; late appeals may be accepted for good cause.
If SSA approves your SSA-44 or reconsideration, it will adjust your IRMAA and refund any overpaid premiums.
Step-by-step: Using Form SSA-44 (life-changing event route)
- Download/complete SSA-44 and select your LCE type. Attach proof (e.g., retirement letter showing last day of work and reduced income).
- Estimate your current-year MAGI (post-event). Be realistic—SSA may request additional verification.
- Submit online via SSA’s “Request to lower an IRMAA” portal or deliver to your local SSA office. Keep copies.
- Watch for SSA’s decision. If denied and you still disagree, you can move to a reconsideration.
Paying IRMAA: don’t miss this Part D wrinkle
- Part B IRMAA is usually added automatically to your monthly Part B bill (or taken from your Social Security payment).
- Part D IRMAA is billed separately by Medicare—not your drug plan or former employer. If you don’t pay it, Medicare can instruct your plan to disenroll you after a grace period. That can mean losing drug coverage and facing late-enrollment penalties later. Set alerts and pay that bill on time.
“Hold Harmless” doesn’t protect people who pay IRMAA
The Social Security hold harmless rule (which can shield checks from being reduced by Part B premium hikes) does not apply to beneficiaries who owe IRMAA. If you’re in an IRMAA bracket, premium increases can fully apply.
Smart planning to avoid or limit IRMAA (without giving up care)
You can’t always dodge IRMAA—and that’s okay; it often means you had strong income. But thoughtful planning can smooth spikes that push you over a bracket:
- Mind the 2-year look-back. Your age-63/64 decisions may affect your IRMAA at 65/66. If you’re planning a Roth conversion, business sale, or large capital gain near Medicare enrollment, consider spreading income over multiple years.
- Use Qualified Charitable Distributions (QCDs). If you’re 70½+, a QCD from a traditional IRA (up to indexed annual limits) excludes that amount from your AGI, which can help IRMAA. QCDs also count toward RMDs. (Confirm eligibility and mechanics with your custodian/CPA.)
- Sequence withdrawals intentionally. Balance taxable, tax-deferred, and Roth accounts to stay under a desired bracket when possible. Multi-year partial Roth conversions during lower-income years can reduce future RMDs and potential IRMAA exposure.
- Watch tax-exempt interest. Municipal bond interest still counts in MAGI for IRMAA—don’t ignore it.
- Revisit status and timing. Filing status and timing of one-time events (e.g., real-estate sales exceeding the exclusion, trust distributions) can matter. Plan ahead with your advisor during tax-projection season.
Tip: Build a simple IRMAA checkpoint into your annual fall review: project year-end MAGI, compare to the current brackets, and adjust withdrawals/realizations if you’re just over a threshold.
Common mistakes to avoid
- Ignoring the separate Part D IRMAA bill. This one causes the most headaches—miss it and you can be disenrolled from drug coverage.
- Assuming Part D plan shopping will lower IRMAA. IRMAA is separate from plan premiums and doesn’t fall if you choose a cheaper plan.
- Waiting too long to appeal. The general window is 60 days from receipt of the notice; late filings must show good cause.
- Claiming non-qualifying “events.” Market dips or routine spending changes aren’t LCEs. Stick to SSA’s list (retirement/work reduction, divorce, death of spouse, etc.).
IRMAA can significantly increase Part B and Part D costs for higher-income retirees—but it doesn’t have to be a surprise. Know the 2025 brackets, keep an eye on MAGI drivers (RMDs, conversions, gains), and use SSA-44 when a qualifying life-changing event lowers your income. Above all, pay your Part D IRMAA bill promptly to avoid disenrollment, and review your income strategy every fall to keep premiums predictable.
If you want, I can also convert this into a CMS-ready post with meta title/description, a compact comparison table for Single vs. MFJ vs. MFS, and a printable SSA-44 checklist.
FAQs
Not permanently. SSA recalculates each year using the most recent IRS data available (generally a 2-year look-back). If a life-changing event permanently lowered your income and you file SSA-44, your IRMAA may drop or disappear—for that year. You’ll be reassessed annually.
A one-time spike (e.g., large conversion or asset sale) can push you into IRMAA for up to a year. That usually doesn’t qualify as an LCE for SSA-44, but the surcharge can fall off the following year if your MAGI drops. Careful multi-year planning can mitigate future spikes.
There’s no strict response deadline for reconsiderations. SSA-44 (new initial determinations) and reconsiderations vary in processing time. If you’re denied, you can continue up the appeals chain (hearing, etc.).