Understanding IRMAA and Your Medicare Premiums
What is IRMAA?
When you sign up for Medicare, you expect to pay the standard Part B and Part D premiums. But if your income is above certain levels, the government adds an extra charge called the Income-Related Monthly Adjustment Amount (IRMAA).
Simply put: the more income you report, the higher your Medicare premiums may be.
Who Decides IRMAA?
The Social Security Administration (SSA) determines IRMAA based on your IRS tax return—usually from two years prior.
What Counts Toward IRMAA?
They look at your Modified Adjusted Gross Income (MAGI), which includes:
Wages, pensions, and Social Security benefits
Withdrawals from retirement accounts (IRA/401k RMDs)
Roth conversions
Dividends, capital gains, and interest
Rental property income
Anything on Line 2a (tax-exempt interest) or Line 11 (AGI) of your 1040 tax return
What Doesn’t Count Toward IRMAA?
Not all income sources impact IRMAA. Some common items that do not count include:
Qualified Roth IRA withdrawals
HSA withdrawals for qualified medical expenses
Life insurance death benefits
Reverse mortgage proceeds
Gifts and inheritances
Qualified disaster relief payments
Veterans’ benefits
Workers’ compensation
Return of your own after-tax contributions (basis)
If it’s not in your AGI and not added back as tax-exempt interest, it usually doesn’t count toward IRMAA.
How Much Could IRMAA Add to Your Premiums?
The chart below shows the projected IRMAA brackets for 2025. Medicare looks at your income from two years prior (usually your 2023 tax return) to determine whether you’ll pay these extra amounts.
If your income is under the first threshold, you’ll pay only the standard Medicare Part B and Part D premiums.
If your income falls into one of the higher brackets, you’ll see an additional monthly charge added to your bill.
These surcharges apply per person — so if you and your spouse are both on Medicare, each of you may be subject to IRMAA.
👉 Example: A married couple with a joint income of $280,000 will each pay an extra $185/month for Part B and $35.30/month for Part D in 2025.
📌 Planning ahead and knowing where your income falls can make a big difference. Sometimes, timing withdrawals or Roth conversions wisely can help you manage these surcharges.
Part B Premium (Including high income Part B & Part D)
[Paid to Medicare]
The standard Part B premium is $185/mo
Higher income earners pay a Part B IRMAA (Income Related Monthly Adjustment Amount) In Addition to the $185/mo standard premium (see table below)
Higher income earners who enroll in PartD Prescription Drug coverage also pay a Part D IRMAA in addition to the monthly insurance premium for a Part D prescription drug plan or medicare advantage plan that includes Part D coverage (see table below).
| If your MAGI (Modified Adjusted Gross Income)* in 2023 was… | Individual Tax Return | Joint Tax Return | Married & Separate Tax Return | You pay in 2025 (per person) Monthly premiums to Medicare Part B Premium + IRMAA |
Part D IRMAA (in addition to Part D plan premium) |
|---|---|---|---|---|---|
| $106,000 or less | $106,000 or less | $212,000 or less | $106,000 or less | $185 | --- |
| $106,001 to $133,000 | $106,001 to $133,000 | $212,001 to $266,000 | N/A | $259 (185 + 74) | + $13.70 |
| $133,001 to $167,000 | $133,001 to $167,000 | $266,001 to $334,000 | N/A | $370 (185 + 185) | + $35.30 |
| $167,001 to $200,000 | $167,001 to $200,000 | $334,001 to $400,000 | N/A | $480.90 (185 + 295.90) | + $57.00 |
| $200,001 to $499,999 | $200,001 to $499,999 | $400,001 to $749,999 | $106,001 to $393,999 | $591.90 (185 + 406.90) | + $78.60 |
| $500,000+ | $500,000+ | $750,000+ | $394,000+ | $628.90 (185 + 443.90) | + $85.80 |
* 2023 MAGI = Adjusted Gross Income (Form 1040 line 11) + Tax-Exempt Interest (Form 1040 line 2a)
These surcharges apply whether you choose a Medicare Supplement or a Medicare Advantage plan. If you’re comparing options, see our [Medicare Advantage vs. Supplement] page.
Key Takeaways About IRMAA
Based on past income: IRMAA for 2025 uses your 2023 tax return.
Applies per person: Each spouse on Medicare may pay the surcharge.
Increases with income: Higher brackets = higher monthly costs.
Can be appealed: Life-changing events may qualify you for relief.
💡 Even small decisions about income, withdrawals, or conversions can mean hundreds (or thousands) of dollars in premium savings.
Can You Appeal IRMAA?
Yes. If you’ve had a life-changing event that reduced your income, you can request a new determination with Social Security. Examples include:
Retirement or reduced work hours
Divorce or death of a spouse
Loss of pension income
Loss of income-producing property
You’ll need to submit Form SSA-44 with supporting documentation to appeal.
How We Help
You don’t have to face IRMAA surprises alone. At Mere, we:
Explain IRMAA in plain language so you know what to expect.
Review your situation to see if you qualify for an appeal.
Guide you step-by-step through the appeal process.
Coordinate with your tax professional to align your Medicare and financial planning.
Take Control of Your Medicare Costs
You worked hard for your retirement—you shouldn’t be caught off guard by unexpected surcharges.
👉 Schedule a no-cost consultation with our team today.
We’ll walk you through your Medicare premiums, help you understand IRMAA, and see if there are ways to reduce your costs.appeal.
Quick Links
Schedule a Call
Licensed Insurance Agency
Not connected with or endorsed by the United States government or the federal Medicare program
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Medicare has neither reviewed nor endorsed this information. Not affiliate with or endorsed by the United States government, the federal Medicare program. Social Security, or
Healthcare.gov.
Accessibility:
We are committed to making our website accessible to everyone. If you have any difficulty accessing our site, please call us at 904-654-5450 or email us at
[email protected]. We’ll be happy to help.
© Copyright 2025. Mere Benefits. All Right Reserved