An income-related monthly adjustment amount (IRMAA) is a surcharge added to your monthly Medicare Part B and Part D premiums based on your annual income.
Many parts of Medicare involve paying a monthly premium. In some cases, your monthly premium may be adjusted based on your income, such as with an IRMAA, which applies to Medicare beneficiaries with higher incomes.
The Social Security Administration (SSA) uses your income tax information from 2 years ago to determine if you owe an IRMAA in addition to your monthly premium.
The surcharge amount you’ll pay depends on factors like your income bracket and how you’ve filed your taxes.
You can appeal IRMAA decisions if there’s an error in the tax information or if you’ve experienced a life changing event that reduced your income.
The SSA determines your IRMAA based on information provided by the Internal Revenue Service (IRS). You can receive a notice from the SSA regarding an IRMAA any time of the year.
If the SSA decides that an IRMAA applies to your Medicare premiums, you’ll receive a predetermination notice in the mail. This will inform you about your specific IRMAA and will also include information such as:
- how the IRMAA was calculated
- what to do if the information used to calculate the IRMAA is incorrect
- what to do if you had a reduction in income or a life changing event
You’ll then receive an initial determination notice in the mail 20 days or more after getting the predetermination notice. This will include information about the IRMAA, when it goes into effect, and steps that you can take to appeal it.
You won’t have to take any additional action to pay the surcharges associated with the IRMAA. They will be automatically added to your premium bills.
Each year, the SSA reevaluates whether an IRMAA should apply to your Medicare premiums. So, depending on your income, an IRMAA could be added, updated, or removed.
Medicare has several parts, each covering a different type of health-related service. Below, we’ll break down the parts of Medicare and review whether they’re affected by IRMAA.
Original Medicare Part A
Part A covers inpatient hospital care. It covers inpatient stays at locations such as hospitals, skilled nursing facilities, and mental health facilities.
IRMAA doesn’t affect Part A, and in most cases, people with Part A don’t pay a monthly premium.
Original Medicare Part B
Part B covers outpatient medical services. It covers:
- various outpatient health services
- durable medical equipment
- some types of preventive care
- limited prescription medications
An IRMAA can affect your Part B monthly premium cost. Based on your annual income, an IRMAA surcharge may be added to the standard Part B premium. We’ll discuss how this surcharge works in the next section.
Medicare Part D
Part D covers prescription medications. Part D plans are administered by private insurance companies.
Part D plans are affected by IRMAA. As with Part B, a surcharge based on your yearly income can be added to your monthly premium. This is separate from the surcharge that can be added to Part B premiums.
Medicare Advantage (Medicare Part C)
Private insurers also administer Medicare Advantage plans, which are sometimes referred to as Medicare Part C. These plans include the benefits of Original Medicare and often cover additional services that Part A and Part B don’t cover, such as:
Most Medicare Advantage plans also include coverage for prescription medications.
Medicare Advantage premiums are also affected by IRMAA.
In 2025, the standard monthly premium for Part B is $185. Depending on your annual income, you may have an additional IRMAA surcharge. The standard monthly premiums typically increase slightly yearly, so the 2026 standard premium may be higher.
This amount is calculated using your income tax information from 2 years ago. So, for 2025, your tax information from 2023 will be assessed.
Surcharge amounts vary based on your income bracket and how you filed your taxes. The 2025 IRMAA brackets and associated premiums include:
| Yearly income in 2023: individual | Yearly income in 2023: married, filing jointly | Yearly income in 2023: married, filing separately | 2025 Part B monthly premium |
|---|---|---|---|
| $106,000 or less | $212,000 or less | $106,000 or less | $185 |
| greater than $106,000 up to $133,000 | greater than $212,000 up to $266,000 | — | $259 |
| greater than $133,000 up to $167,000 | greater than $266,000 up to $334,000 | — | $370 |
| greater than $167,000 up to $200,000 | greater than $334,000 up to $400,000 | — | $480.90 |
| greater than $200,000 up to $500,000 | greater than $400,000 up to $750,000 | greater than $106,000 up to $394,000 | $591.90 |
| $500,000 or more | $750,000 or more | $394,000 or more | $628.90 |
If inflation remains constant, the projected 2026 IRMAA brackets and associated premiums, based on the 2024 Medicare Trustees Report, include:
| Yearly income in 2024: individual | Yearly income in 2024: married, filing jointly | Projected 2026 Part B monthly premium |
|---|---|---|
| $107,000 or less | $214,000 or less | $186.90 |
| greater than $107,000 up to $134,000 | greater than $214,000 up to $268,000 | $261.70 |
| greater than $134,000 up to $169,000 | greater than $268,000 up to $338,000 | $373.80 |
| greater than $169,000 up to $202,000 | greater than $338,000 up to $404,000 | $485.90 |
| greater than $202,000 up to than $500,000 | greater than $404,000 up to $750,000 | $598.10 |
| $500,000 or more | $750,000 or more | $635.50 |
Part B projections for those married but filing their taxes separately are not currently available.
There are no standard monthly premiums for Part D prescription drug plans, as the insurers administering the plans determine them. However, a surcharge will be added to the monthly premium based on your income tax information from 2 years ago.
As with Part B, your income bracket and how you’ve filed your taxes impact the surcharge amount.
The additional surcharge for Part D is paid directly to Medicare, not your plan’s provider. The table below provides information on the Part D surcharge amounts for 2025:
| Yearly income in 2023: individual | Yearly income in 2023: married, filing jointly | Yearly income in 2023: married, filing separately | 2025 Part D monthly surcharge |
|---|---|---|---|
| $106,000 or less | $212,000 or less | $106,000 or less | $0.00 + your plan premium |
| greater than $106,000 up to $133,000 | greater than $212,000 up to $266,000 | — | $13.70 + your plan premium |
| greater than $133,000 up to $167,000 | greater than $266,000 up to $334,000 | — | $35.30 + your plan premium |
| greater than $167,000 up to $200,000 | greater than $334,000 up to $400,000 | — | $57.00 + your plan premium |
| greater than $200,000 up to $500,000 | greater than $400,000 up to $750,000 | greater than $106,000 up to $394,000 | $78.60 + your plan premium |
| $500,000 or more | $750,000 or more | $394,000 or more | $85.80 + your plan premium |
If inflation remains constant, the projected 2026 IRMAA brackets and associated premiums, based on the 2024 Medicare Trustees Report, include:
| Yearly income in 2024: individual | Yearly income in 2024: married, filing jointly | Projected 2026 Part D monthly premium |
|---|---|---|
| $107,000 or less | $214,000 or less | $0.00 + Part D premium |
| greater than $107,000 up to $134,000 | greater than $214,000 up to $268,000 | 2026 Part D Premium + $14.50 |
| greater than $134,000 up to $169,000 | greater than $268,000 up to $338,000 | 2026 Part D Premium + $37.50 |
| greater than $169,000 up to $202,000 | greater than $338,000 up to $404,000 | 2026 Part D Premium + $60.40 |
| greater than $202,000 up to than $500,000 | greater than $404,000 up to $750,000 | 2026 Part D Premium + $83.30 |
| $500,000 or more | $750,000 or more | 2026 Part D Premium + $91.00 |
Part D projections for those married but filing their taxes separately are not currently available.
If you don’t believe you should owe an IRMAA, the first step is to apply for a reconsideration. This can be done by calling SSA or mailing a written notice.
If this does not resolve the issue, the next step is to appeal the decision. Let’s take a closer look at how this process works.
When can I appeal?
You can appeal an IRMAA decision within 60 days of receiving an IRMAA determination notice in the mail. The SSA will evaluate whether you have good cause for a late appeal outside of this time frame.
In what situations can I appeal?
There are two situations when you can appeal an IRMAA.
The first situation involves the tax information used to determine the IRMAA. Some examples include:
- The data used by the SSA to determine the IRMAA is incorrect.
- The SSA used older or out-of-date data to determine the IRMAA.
- You filed an amended tax return during the year the SSA uses to determine the IRMAA.
The second situation involves life changing events that significantly impact your income. There are seven qualifying events:
- marriage
- divorce or marriage annulment
- death of a spouse
- reduction in work
- cessation of work
- loss or reduction of specific types of pensions
- loss of income from an income-generating property
What documentation will I need to provide?
The documents you must provide for your appeal depend on your situation. They might include:
- federal income tax returns
- marriage certificate
- decree of divorce or marriage annulment
- death certificate
- copies of pay stubs
- a signed statement from your employer indicating reduction or stoppage of work
- letter or statement indicating a loss or reduction of a pension
- statement from an insurance adjuster indicating the loss of an income-generating property
How do I submit an appeal?
An appeal may not be necessary. The SSA sometimes performs a new initial determination using updated documentation. If you’re not eligible for a new initial determination, you can appeal the IRMAA decision.
You can contact the SSA to begin the appeals process. Your initial determination notice should also have information on how to do this. If the SSA reviews and approves your appeal, your monthly premiums will be corrected. If your appeal is denied, the SSA can provide you with instructions on how to appeal the denial in a hearing.
Resources for additional helpIf you have questions or concerns about Medicare, IRMAA, or getting help with paying your premiums, consider using the following resources:
- Medicare: You can contact Medicare directly at 800-Medicare to get information on benefits, costs, and assistance programs like Medicare Savings Programs and Extra Help. You can also get help with claims and appeals online.
- SSA: To get information about IRMAA and the appeals process, the SSA can be contacted directly at 800-772-1213.
- SHIP: The State Health Insurance Assistance Program (SHIP) provides free assistance with your Medicare questions. You can find out how to contact your state’s SHIP program here.
- Medicaid: Medicaid is a joint federal and state program that assists people who have a lower income or resources with their medical costs. You can find more information or check if you’re eligible on the Medicaid site.
IRMAA is an additional surcharge that can be added to your monthly Medicare premiums based on your yearly income. It applies only to Medicare parts B and D.
The SSA uses your income tax information from 2 years ago to determine whether you owe an IRMAA. The surcharge amount you may need to pay is determined based on your income bracket and how you filed your taxes.
In some cases, you can appeal IRMAA determinations. If you received a notice about an IRMAA and believe you don’t need to pay the surcharge, contact the SSA to learn more.