What is Medicare IRMAA, and will I have to pay it?

• IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra amount on top of your Part B premium (doctor visits and outpatient care), your Part D drug plan premium (prescription drug coverage), or both. A premium is what you pay every month to have coverage.
• It's based on your tax return from two years earlier. For 2026 premiums, that's your 2024 return.
• For 2026, about 8% of people with Part B pay IRMAA, and about 8% of people with Part D pay the Part D amount.
• Social Security decides it, using tax information the IRS sends. If it applies to you, the notice usually comes in November.
• If your income dropped because of one of eight specific life events, you can ask Social Security for a new decision. That is a request, not an appeal.
• The amounts on this page are 2026 amounts. The 2027 amounts haven't been announced yet.

A letter that raises your Medicare bill is hard to take, especially after you've stopped working and your income has dropped. The reason it can happen is timing.

Social Security looks at the tax return from two years before the premium year. If that return isn't available, it can go back further, but no more than three years. So 2026 premiums use your 2024 return, and under the same rule 2027 premiums would generally use your 2025 return.

That gap is why someone who has just retired can still be charged based on the years they were working. The section on reducing IRMAA, further down, covers what you can do about it.

The number Social Security uses is your modified adjusted gross income, or MAGI. For IRMAA, that means the adjusted gross income on your tax return plus any tax-exempt interest (interest the IRS doesn't tax).

Your Part B premium, with any IRMAA in it, is usually taken out of your Social Security (or Railroad Retirement) payment. If that doesn't apply to you, Medicare bills you every 3 months. The Part D amount works differently. It's paid on top of your drug plan's premium, and it's deducted from Social Security or paid directly to Medicare, not to the plan.

For 2026, if your 2024 income was $109,000 or less ($218,000 or less filing jointly), you pay the standard Part B premium of $202.90 a month. Above that, it rises in five steps to $689.90 a month at $500,000 or more ($750,000 or more filing jointly).

These are monthly amounts for 2026, based on 2024 income. The more your income was over the limit, the bigger the extra amount. The steps are called brackets.

The "Part B extra" column is the IRMAA itself. The total column is your whole monthly Part B premium, standard amount included. The first row is the standard premium, with no IRMAA. The Part D column is only the extra amount, on top of whatever your drug plan charges.

If you're married and file separately, the 2026 amounts work differently. With 2024 income of $109,000 or less, you pay the standard Part B premium of $202.90 and no Part D add-on. Above $109,000 and under $391,000, Part B is $649.20 and the Part D add-on is $83.30. At $391,000 or more, Part B is $689.90 and the Part D add-on is $91.00.

What about 2027? Medicare announces the next year's amounts in the fall. The 2026 amounts came out in mid-November 2025. As of October 7, 2026, the 2027 amounts haven't been announced, so we haven't printed any guesses. Under the same two-year rule, 2027 premiums would generally look at your 2025 income.

If your income dropped because of one of eight life events, such as stopping work, cutting back work or a spouse's death, you can ask Social Security for a new decision based on a more recent year, usually with Form SSA-44. A few other situations, like an amended tax return, have their own route (see the appeal section below). Stopping work is one of the eight, and a retirement letter is one of the documents Social Security accepts as proof. A drop in income for a reason that isn't on the list doesn't qualify for this request.

This is not an appeal. Social Security treats it as a request for a new decision. The old decision stays in place until the new one is made. The formal appeal is a separate route, covered below.

The eight events, in plain words

1. Your spouse died.
2. You got married.
3. You got divorced, or your marriage was annulled.
4. You cut back on work.
5. You stopped working.
6. You lost property that brought in income, in a way you didn't choose. Social Security's examples are a disaster, arson, the government taking the property, and theft or fraud.
7. Your pension income was reduced or lost. This one is narrower than it sounds. The proof Social Security lists is a letter from the plan administrator saying a defined-benefit or cash-balance plan failed or ended.
8. Your employer, or a former employer, paid you a settlement because it closed, went bankrupt or reorganized. Ordinary severance pay isn't this event.

What doesn't count

Social Security does not accept a one-time spike as a reason for a reduction. It names large capital gains, lottery or casino winnings, IRA conversions and cashing in bonds.

What to bring

An estimate of your MAGI and your filing status for the year you're asking about, or a signed copy of a newer tax return that shows a significant drop. Social Security can base the new decision on the year the life event happened or a later year.

How to ask

Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event) is the usual way to ask, but it's optional. You can also ask by speaking with Social Security or in writing.

Going deeper: the proof Social Security accepts

• Spouse died: a death certificate.
• Marriage: a marriage certificate. Divorce: a divorce decree.
• Stopped or cut back work: an employer statement, a retirement letter, pay stubs, or a statement you sign yourself under penalty of perjury.
• Lost property: the loss has to be involuntary. For investment fraud, Social Security needs a conviction.
• Pension: the plan administrator's letter described above.
• Employer settlement: it has to come from a closure, bankruptcy or reorganization. Ordinary severance is not the same thing.

If you think the decision itself is wrong, the formal appeal is called reconsideration. You have 60 days from when you receive your notice to ask, and Social Security counts you as having received it 5 days after the date on the notice. You ask on Form SSA-561-U2 at a local Social Security office. If you disagree with that result, there are further steps: an administrative law judge, the Medicare Appeals Council, then federal court.

Going deeper: other reasons Social Security will look again

A few other situations can change the decision. They are separate from the eight events and from Form SSA-44: you amended your tax return, the IRS data Social Security used was corrected, Social Security used a tax return three years old, or you're married, file separately, and lived apart from your spouse all year.

For IRMAA, income means your MAGI: the adjusted gross income on your tax return plus tax-exempt interest. Here is how a few common sources of money fit in.

This isn't a full list. Other kinds of income can matter too, and your tax return is where to see your real number. This page is general information, not tax advice.

• Expecting IRMAA to follow this year's income. It follows your return from two years back. That's why it can land on someone who just retired.
• Calling the request an appeal. Asking for a reduction after a life event is a request for a new decision. The formal appeal is a separate route with a 60-day limit.
• Assuming any drop in income qualifies. Only the eight events do. A one-time spike doesn't count as an event, and ordinary severance isn't the employer settlement in number 8.
• Sending the request before the proof is ready. If Social Security doesn't receive your proof within 30 days (90 if it extends the time), it dismisses the request.
• Looking for the Part D amount on your drug plan's bill. It's paid on top of the plan premium, and it goes to Medicare or comes out of Social Security, not to the plan.