What Is Medicare's Income-Related Monthly Adjustment Amount (IRMAA)?
Key takeaways:
The income-related monthly adjustment amount (IRMAA) is a premium surcharge paid by Medicare enrollees with high incomes. IRMAA can increase your Part B premium and/or your Part D premium. You can face IRMAA charges whether you have original Medicare or a Medicare Advantage plan.
In 2025, you may be subject to an IRMAA surcharge if your 2023 modified adjusted gross income exceeded $106,000 for an individual or was above $212,000 for a couple filing a joint federal tax return.
You can file an appeal to reduce or eliminate the IRMAA surcharge if you have had a life-changing event such as a divorce, deceased spouse, or reduced income.
Table of contents
Most Medicare enrollees don’t need to think about their Part B premium for preventive and outpatient care because it’s automatically deducted from their monthly Social Security benefits. Your Medicare Part D coverage has a base premium, whether it’s included in a Medicare Advantage plan or you have a standalone Part D prescription plan.
If you have a high income, you will likely pay more for Medicare Part B and Part D. Learn more about this upcharge on your premiums, which is called the income-related monthly adjustment amount or IRMAA.
What is Medicare’s income-related monthly adjustment amount?
The income-related monthly adjustment amount (IRMAA) is a premium surcharge paid by Medicare enrollees with high incomes. You can be charged the IRMAA on Part B and/or Part D. The IRMAA is applied whether you are covered by original Medicare or a Medicare Advantage plan. Being charged the IRMAA can mean paying twice as much — or more — for your Part B and Part D premiums.
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The U.S. Social Security Administration determines who pays the IRMAA based on IRS data. Your status can change annually because your income can change. You are charged an IRMAA based on your modified adjusted gross income (MAGI) from 2 years prior. Your MAGI may be very close to your adjusted gross income (AGI), a figure that appears on IRS Form 1040, line 11. (MAGI doesn’t appear on your federal tax return.)
Your 2023 MAGI will determine whether you pay IRMAA upcharges for the 2025 coverage year. Reported income from 2 years prior is typically the most current data available because Medicare annual open enrollment periods for 2025 close before most people will file their 2024 tax returns.
If you are going to be charged an IRMAA for Part B and/or Part D, you should receive a notice from the Social Security Administration called an initial IRMAA determination — which will also outline your rights to an appeal.
Most Medicare enrollees do not pay an IRMAA. According to the 2024 Medicare Trustees Report, 4.9 million people paid the Part B IRMAA in 2024, which is about 7% of enrollees. Not everyone with Medicare has a prescription plan, but 4.2 million people paid a Part D IRMAA in 2024.
Which premiums does IRMAA increase?
IRMAA can increase Part B premiums and Part D premiums. The upcharge on your Part B premium is typically a different amount than what’s added to your Part D premium.
Medicare covers prescriptions in three main ways:
Within a Medicare Advantage plan
As a standalone Part D plan with its own premium because you have original Medicare (Part A and/or Part B)
As a standalone Part D plan with its own premium because your Medicare Advantage plan doesn’t cover prescription medications
Part A premiums are based on work history. Most people don’t pay anything for Medicare Part A hospital insurance. But you can be charged $285 or $518 per month in 2025 if you or a spouse don’t have enough credit from paying Medicare taxes.
Part B premiums increased in 2025. The standard Part B premium, which covers preventive and outpatient care, is $185 a month in 2025 — an increase of $10.30 from 2024.
Medicare enrollees can get most vaccines for $0 out of pocket. You can get vaccines without paying deductibles and copays if you’re covered by Part B and/or a Part D prescription plan.
What are the IRMAA brackets for Medicare?
In 2025, you qualify for IRMAA if your income exceeded $106,000 as an individual or was more than $212,000 as a married couple filing jointly based on your 2023 federal income tax return.
Here are charts showing income ranges and the associated IRMAA surcharges for Part B premiums and Part D premiums.
Part B IRMAA surcharges in 2025
Part B monthly premium in 2025 | Income on 2023 individual tax return | Income on 2023 joint tax return | Income for a married person filing separate 2023 tax return |
$185 standard premium (no IRMAA) | $106,000 or less | $212,000 or less | $106,000 or less |
$259 | Above $106,000-$133,000 | Above $212,000-$266,000 | Not applicable |
$370 | Above $133,000-$167,000 | Above $266,000-$334,000 | Not applicable |
$480.90 | Above $167,000-$200,000 | Above $334,000-$400,000 | Not applicable |
$591.90 | Above $200,000 and less than $500,000 | Above $400,000 and less than $750,000 | Above $106,000 and less than $394,000 |
$628.90 | $500,000 or more | $750,000 or more | $394,000 or more |
Source: Medicare.gov
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Part D IRMAA surcharges in 2025
Part D monthly premium in 2025 | Income on 2023 individual tax return | Income on 2023 joint tax return | Income for a married person filing separate 2023 tax return |
Your plan premium | $106,000 or less | $212,000 or less | $106,000 or less |
$13.70 + your plan premium | Above $106,000-$133,000 | Above $212,000-$266,000 | Not applicable |
$35.30 + your plan premium | Above $133,000-$167,000 | Above $266,000-$334,000 | Not applicable |
$57 + your plan premium | Above $167,000-$200,000 | Above $334,000-$400,000 | Not applicable |
$78.60 + your plan premium | Above $200,000 and less than $500,000 | Above $400,000 and less than $750,000 | Above $106,000 and less than $394,000 |
$85.80 + your plan premium | $500,000 or more | $750,000 or more | $394,000 or more |
Source: Medicare.gov
Paying your IRMAA
Here’s how to pay your IRMAA surcharges for Part B and Part D.
Part B premium
Your Part B IRMAA is automatically added to your Part B premium bill and deducted from your Social Security benefits. If you don’t receive Social Security (or Railroad Retirement Board benefits), you will need to pay your Part B IRMAA directly to Medicare. You should get a bill every 3 months.
Part D premium
You must pay your Part D IRMAA directly to Medicare — and not your Part D prescription plan, your employer, or any entity that may pay your Part D premium. You can arrange to have the Part D IRMAA deducted from your Social Security benefits. But you must pay the surcharge directly to Medicare until that automatic payment begins.
You are responsible for paying the Part D IRMAA whether it’s included in a Medicare Advantage plan or a standalone Part D plan — or you’ll lose your prescription coverage.
Is IRMAA permanent?
Maybe. If you continue to have a high income and you remain enrolled in a Medicare plan, IRMAA surcharges will be added to your premiums. If your income fluctuates, then you won’t be subject to the surcharge if your income falls below the threshold.
Can you get rid of IRMAA charges?
IRMAA surcharges are based on your income from 2 years ago. But your present financial situation may be different. You may be able to avoid paying higher premiums by appealing the IRMAA determination.
You can file an IRMAA appeal for many reasons, such as:
Wrong information was used to determine your income or filing status.
You filed an amended tax return.
You have a more recent return showing lower income.
Your income has changed because of divorce.
Your income has changed because of retirement.
Your income has changed because your spouse died.
An appeal is a request to reduce or eliminate an IRMAA. To appeal, you complete a life-changing event form explaining your situation and attach supporting documents about your change in income. If Social Security approves your appeal, your premiums will be adjusted. If you’re denied, you can request further reviews and consideration from Medicare and the federal courts.
If you need help with an IRMAA appeal or have questions, you can:
Call the U.S. Social Security Administration at 800-772-1213.
Contact your State Health Insurance Assistance Program (SHIP) for guidance.
Call the Medicare Rights Center at 800-333-4114 and ask to speak to a counselor.
You can also hire specialized consultants and companies to help you draft and file the paperwork needed to appeal IRMAA surcharges.
How can you avoid IRMAA for Medicare?
The simple way to avoid IRMAA is to have income below the threshold. Talk to a tax professional or financial advisor about ways you may be able to reduce your IRMAA risk — especially if your MAGI is close to the threshold.
It may be too late to avoid IRMAA for the 2025 coverage year. But you can take actions at the end of 2024 and in the early months of 2025 to potentially sidestep IRMAA in 2026.
Some financial planning strategies that can help include:
Prepaying tax payments: Paying first-quarter 2025 mortgage interest or real estate tax payments by the end of 2024 may allow you to deduct them on your 2024 tax returns.
Making qualified charitable distributions: People 70½ and older must take a required minimum distribution from their IRA accounts. Instead of withdrawing the amount and making a charitable contribution yourself, you can have your IRA trustee make a qualified charitable distribution directly to an eligible organization. This way, you make the financial gift while reducing your MAGI, which may help you lower or avoid IRMAA.
Do IRMAA brackets change from year to year?
Yes. The threshold and income bands typically change annually. For instance, IRMAA was triggered at incomes above $103,000 in 2024 and increased to a threshold of more than $106,000 for the 2025 coverage year.
The bottom line
Most Medicare enrollees pay standard premiums for Part B and Part D coverage. But some people with higher incomes pay more for their insurance. This premium surcharge is the income-related monthly adjustment amount (IRMAA).
In 2025, you may be subject to an IRMAA surcharge if your 2023 modified adjusted gross income was above $106,000 for an individual and more than $212,000 for a couple filing a joint federal tax return.
You can file an appeal to reduce or eliminate an IRMAA surcharge if you have a life-changing event such as a divorce, deceased spouse, or documentation of a lower income. You also may be able to use financial planning strategies to reduce your IRMAA risk, especially if your income is near the threshold.
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References
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