Medicare’s income-related monthly adjustment amount (IRMAA) is a surcharge that may be added to your monthly Part B and Part D premiums if your yearly income exceeds a certain amount.
Each year, the United States Social Security Administration establishes IRMAA income brackets that determine whether you need to pay fees on top of your Medicare Part B and D premiums.
For example, if you’ve signed up for Medicare Part B (medical insurance) and/or Medicare Part D (prescription drugs) and your yearly income is above the Medicare-determined annual thresholds, you may have an additional surcharge added to your monthly premiums.
IRMAA is calculated on a sliding scale of income brackets. These amounts are adjusted every year to account for inflation. In addition, the IRMAA income adjustments have a 2-year time lag. That means what you owe in 2025 is based on your 2023 tax returns.
Glossary of common Medicare terms
- Out-of-pocket cost: This is the amount you pay for care when Medicare doesn’t pay the full cost or offer coverage. It includes premiums, deductibles, coinsurance, and copayments.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is the annual amount you must spend out of pocket before Medicare begins to cover services and treatments.
- Coinsurance: This is the percentage of treatment costs you’re responsible for paying out of pocket. With Medicare Part B, you typically pay 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments or services. With Medicare, this often applies to prescription medications.
In 2024, if your 2022 income exceeded $103,000 (for an individual return) or $206,000 (for a joint return), you will pay an extra amount on top of your plan’s Part B and Part D premiums.
The table below shows what you paid in 2024 based on your 2022 single and married (joint) tax returns:
| 2022 individual tax return | 2022 joint tax return | Part B adjusted amount (IRMAA) | Part D adjusted amount (IRMAA) |
|---|---|---|---|
| $103,000 or less | $206,000 or less | $0 | $0 |
| greater than $103,000 and up to $129,000 | greater than $206,000 and less than or equal to $258,000 | $69.90 | $12.90 |
| greater than $129,000 and up to $161,000 | greater than $258,000 and less than or equal to $322,000 | $174.70 | $33.00 |
| greater than $161,000 and up to $193,000 | greater than $322,000 and less than or equal to $386,000 | $279.50 | $53.80 |
| greater than $193,000 and less than $500,000 | greater than $386,000 and less than $750,000 | $384.30 | $74.20 |
| $500,000 or above | $750,000 or above | $419.30 | $81.00 |
If you were married but filing separately, here were your 2024 IRMAA surcharges:
| Married but filing separately 2022 tax returns | Part B adjusted amount (IRMAA) | Part D adjusted amount (IRMAA) |
|---|---|---|
| greater than $103,000 and up to $397,000 | $384.30 | $74.20 |
| $397,000 or above | $419.30 | $81.00 |
The table below provides the IRMAA brackets for 2025 (based on your 2023 yearly tax returns).
| 2023 individual tax return | 2023 joint tax return | Part B adjusted amount (IRMAA) | Part D adjusted amount (IRMAA) |
|---|---|---|---|
| $106,000 or less | $212,000 or less | $0 | $0 |
| greater than $106,000 and up to $133,000 | greater than $212,000 and less than or equal to $266,000 | $74.00 | $13.70 |
| greater than $133,000 and up to $167,000 | greater than $266,000 and less than or equal to $334,000 | $185.00 | $35.30 |
| greater than $167,000 and up to $200,000 | greater than $334,000 and less than or equal to $400,000 | $295.90 | $57.00 |
| greater than $200,000 and less than $500,000 | greater than $400,000 and less than $750,000 | $406.90 | $78.60 |
| $500,000 or above | $750,000 or above | $443.90 | $85.80 |
If you’re married and filing separately, here are your 2025 IRMAA surcharges:
| Married but filing separately 2023 tax returns | Part B adjusted amount (IRMAA) | Part D adjusted amount (IRMAA) |
|---|---|---|
| greater than 106,000 but less than $394,00 | $406.90 | $78.60 |
| $394,000 or more | $443.90 | $85.80 |
If applicable, Medicare automatically adds Part B IRMAA fees to your monthly premium bill.
If you’ve signed up for Medicare Part D and you owe IRMAA income-adjusted fees, Medicare will send you a bill each month, which you can pay the same way you pay your Part B premiums.
All Medicare bills are due on the 25th of each month. However, if you’ve signed up for Medicare Easy Pay, automatic deductions are on the 20th of the month (or the next business day).
Here are four ways to pay your Medicare premiums:
- Online account: You can pay online through your online Medicare account.
- Medicare easy pay: You can sign up for this free Medicare-provided service that automatically will deduct IRMAA payments from your checking or savings account each month.
- Bank bill pay service: You can use your bank’s online bill payment service.
- Mail: You can also mail your monthly payments to Medicare using a check, money order, credit card, or debit card.
The Social Security Administration uses your modified adjusted gross income (MAGI) to determine whether you need to pay IRMAA fees on top of your Medicare premiums.
Your MAGI is the sum of:
- your adjusted gross income found on line 11 of the Internal Revenue Service (IRS) tax filing form 1040, plus
- your tax-exempt interest income, found on line 2a of IRS Form 1040
The amount you pay is calculated based on your tax returns from 2 years prior. Whether you file your tax returns as an individual or jointly will also affect the amount you pay.
You will receive an official notice by mail, called an Initial IRMAA Determination, if you are subject to additional Part B and/or Part D payments.
Yes. IRMAA decisions can be appealed if there’s an error in the tax information used or you’ve experienced a life changing event that affected your income. Contact the Social Security Administration to begin the appeals process.
Yes. IRMAA takes into account your gross income, your filing status, and any dividends or capital gains that you have earned in the 2 years prior to the IRMAA income brackets used to determine your payments.
Yes. Your Social Security Benefits count toward your modified adjusted gross income (MAGI), and your MAGI determines what your IRMAA payments will be.
IRMAA is an additional surcharge that may be added to your monthly Medicare premiums based on your yearly income. It only applies to premiums for Medicare parts B and D.
The Social Security Administration uses your income tax information from 2 years ago to determine whether you owe an IRMAA. For example, what you owe in 2025 is determined by your 2023 tax returns.
You will receive an official notice by mail from Social Security if you need to pay additional Part B and/or Part D surcharges.