IRMAA Made Simple: What High-Income Retirees Need to Know About Medicare

If your income is over $100,000 as an individual or $200,000 as a couple, there’s a good chance you’ll pay more for Medicare than most people. This extra charge is called the Income-Related Monthly Adjustment Amount, or IRMAA, and it can come as a surprise to many retirees.

At The Medicare Coach, we help clients every year who discover this penalty only after they’ve already started paying higher premiums. The good news? You can often do something about it.

Let’s break it down.

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What Is IRMAA?

IRMAA is an additional amount added to your Medicare Part B (medical coverage) and Part D (prescription coverage) premiums if your income is above certain thresholds.

As of 2025, those thresholds are roughly:

• Over $100,000 if you file taxes individually

• Over $200,000 if you file jointly

If you’re married but file separately, the threshold is around $100,000.

In simple terms, the higher your income, the more you’ll pay each month for Medicare.

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How Does Medicare Decide If You Owe IRMAA?

Medicare doesn’t look at your current income. Instead, it looks back two years using your Modified Adjusted Gross Income (MAGI) from your IRS tax return.

So, your 2025 Medicare costs are based on your 2023 income. Likewise, your 2026 costs will be based on your 2024 income.

This lag means that a high-income year, such as when you sold a home, took a large distribution from a retirement account, or converted to a Roth IRA, could increase your Medicare premiums even after your income goes down.

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How to Know If You’re Paying More

There are two simple ways to find out:

1. Watch your mail. Medicare often sends an initial bill at the standard rate, followed by an updated statement showing the higher IRMAA premium.

2. Log in to your Medicare.gov account. If your monthly premium is higher than the standard amount, you’re paying the IRMAA surcharge.

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Can You Appeal an IRMAA Penalty?

Yes, and many people successfully do.

You can ask Social Security to recalculate your IRMAA if your income has gone down due to what’s called a “life-changing event.”

Qualifying events include:

• Retirement or a reduction in work hours

• Death of a spouse

• Divorce

• Loss of income-producing property

If one of these applies to you, you can submit a form called SSA-44 to report your new, lower income and request an adjustment. You’ll need to provide documentation, but the process is worth it. Our clients who appeal often save thousands, sometimes more than $6,000 per year.

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Why You Should Be Proactive

The government will not automatically lower your IRMAA when your income changes. You have to ask. The longer you wait, the more you’ll pay unnecessarily.

At The Medicare Coach, we’ve seen firsthand how being proactive makes a real difference. One client came to us after retiring midyear. Once we guided them through the appeal, their monthly premiums dropped dramatically, and those savings continued year after year.

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The Bottom Line

If your income has changed or you’re newly retired, don’t assume you’re stuck with the higher Medicare rate. Learn whether you qualify for an IRMAA appeal and take action quickly.

Understanding the rules and knowing when and how to appeal can protect both your healthcare and your retirement savings.

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Need Help Navigating Medicare?

If you’re unsure whether IRMAA applies to you or want independent, step-by-step help with your Medicare enrollment, our Medicare Enrollment Concierge can make the process simple and stress-free.

This personalized, done-for-you service includes:

• Complete Medicare research and recommendations

• One-on-one guidance through your paperwork

• Help with IRMAA appeals, if you qualify

• Annual reviews to ensure you’re never overpaying

Take the stress off your shoulders. Join the Medicare Enrollment Concierge today and get peace of mind knowing your Medicare decisions and your savings are in expert hands.