Medicare question
What Is IRMAA and Which Parts of Medicare Does It Affect?
If you’ve recently received an IRMAA bill, it’s natural to feel confused about what triggered this additional charge. Let's break down what IRMAA means and how it affects your Medicare coverage.
Where this answer comes from, and what it can't tell you
Written from the published Medicare rules and the source material preserved for this question. It explains the topic in general terms. It is not a reading of your own coverage documents, not a prediction of how Medicare or a plan will decide a case, and not advice about a particular plan. Your current notice, policy, Evidence of Coverage, or formulary controls when it differs from a general explanation. Resting Sycamore is not Medicare.gov and is not endorsed by any government agency.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. This is an extra fee that higher-income individuals may have to pay on top of their standard Medicare premiums. The purpose of IRMAA is to ensure that wealthier beneficiaries contribute a larger share toward the cost of their Medicare Part B and Part D coverage.
To determine if you owe IRMAA, the government looks at your income from two years prior to when you enroll in Medicare. If this income exceeds certain thresholds, you will pay higher premiums for these parts of Medicare. The exact amount depends on how much over those thresholds your modified adjusted gross income (MAGI) is.
When Does IRMAA Apply to Medicare Coverage?
IRMAA applies specifically to Medicare Part B and Medicare Part D. These are the two parts that require monthly premiums:
Medicare Part B covers doctor visits, outpatient care, and some preventive services.
Medicare Part D provides prescription drug coverage.
If you have both of these parts, then IRMAA could affect your total premium costs. The amount you pay for IRMAA is based on the income you reported two years earlier on your tax return. This means if you had a high-income year in 2019 and enrolled in Medicare in 2021 or later, you might owe IRMAA.
How Can You Determine Whether You Owe IRMAA?
To figure out whether you are subject to IRMAA, you need to look at your income for the relevant years. The government uses your modified adjusted gross income (MAGI) from two years prior to when you enroll in Medicare. For instance, if you signed up for Medicare Part B or D in 2023, they would use your 2021 tax return.
Here are some key points:
Medicare Part A premiums are not affected by IRMAA. Most people don’t pay a premium for this part of Medicare because they’ve paid into it through their payroll taxes.
Income thresholds change each year. For 2026, IRMAA begins above $109,000 for an individual return and above $218,000 for a joint return.
The government sends out notices (often called “pink slips”) to those who may be required to pay IRMAA. These notices provide detailed information about how much you will owe and when your payments are due.
How Can You Appeal or Pay an IRMAA Amount?
If you receive an IRMAA notice and believe it is incorrect, you can appeal the decision. Common reasons for appealing include changes in marital status, a significant reduction in income, or errors on your tax return from previous years.
To file an appeal:
Gather the documents that support your request and follow the Social Security notice. You can request a new decision after a qualifying life-changing event with Form SSA-44, or appeal an incorrect IRMAA decision through Social Security.
If you agree with the IRMAA amount and need to make a payment, you can do so via automatic bank draft or by mailing a check directly to Medicare. It’s important to pay on time to avoid additional penalties and late fees.
Which Medicare Costs Can IRMAA Affect?
IRMAA is an income-related adjustment added to Part B and Part D costs for people whose income exceeds the applicable thresholds. Social Security uses tax information to make the determination and sends a notice explaining the amount. If the information is wrong or you had a qualifying life-changing event, follow the notice's instructions for requesting a new decision or filing an appeal.
Where should you look next?
What else do people ask about iRMAA?
- IRMAA and Medicare: Why High-Income Retirees Pay More and How to Plan Around It?
- Does a Roth Conversion Affect IRMAA? What to Know Before Converting?
- How to Appeal IRMAA If Your Income Dropped Because of Retirement or a Life Event?
- How RMDs Affect IRMAA and What You Can Do Before They Start?
- Which Tax Year Does Medicare Use to Set My IRMAA? How the Two-Year Lookback Works?
- Do Medigap Premiums Go Up Every Year? Rate Increase History and How to Compare Carriers?
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