What Is the IRMAA and Will It Affect Me

Dvir MoschePosted in Uncategorized last updated on April 15, 2025

What Is IRMAA? (Definition & Overview)

If you’re on Medicare—or about to be—you might hear something called IRMAA. Don’t worry, it’s not as scary as it sounds!

Let’s break it down into plain English sentences.

What Does IRMAA Mean?

IRMAA stands for Income-Related Monthly Adjustment Amount. Whew, that’s a mouthful! 😅

All it really means is this:

If you make more money than most people on Medicare, you may have to pay a little extra each month for your Medicare Part B and Part D plans.

Who Decides If You Pay IRMAA?

That decision comes from the Social Security Administration (SSA). They look at your income from two years ago.

So, if it’s 2025 now, they’re looking at your income from 2023.

Here’s how it works:

The more income you had, the higher your IRMAA payment could be.
If your income is below a certain level, you won’t pay IRMAA.

How IRMAA Connects to Medicare

IRMAA is an extra monthly charge added to:

Medicare Part B – This helps cover doctor visits and outpatient care.
Medicare Part D – This covers your prescription drugs.

So if you get hit with IRMAA, you’ll still pay your regular Medicare premium plus this additional charge.

🔹 Real-Life Example:
Let’s say you and your spouse filed taxes together and your income in 2023 was $210,000.

Because that’s higher than the standard limit, you’d likely have an IRMAA added to your Part B and Part D premiums in 2025.

✅ 2025 IRMAA Income Thresholds

Filing Status	2023 Income Range	Part B Monthly Surcharge	Part D Monthly Surcharge
Single or Head of Household	$103,000 or less	$0.00	$0.00
	$103,001 – $129,000	$69.90	$12.90
	$129,001 – $161,000	$174.70	$33.30
	$161,001 – $193,000	$279.50	$53.80
	$193,001 – $499,999	$384.30	$74.20
	$500,000 or more	$419.30	$81.00
Married Filing Jointly	$206,000 or less	$0.00	$0.00
	$206,001 – $258,000	$69.90	$12.90
	$258,001 – $322,000	$174.70	$33.30
	$322,001 – $386,000	$279.50	$53.80
	$386,001 – $749,999	$384.30	$74.20
	$750,000 or more	$419.30	$81.00

Not everyone has to pay IRMAA.

Whether or not you do depends on how much money you made two years ago (so in 2023 for your 2025 premiums).

The more you make, the more you may have to pay for Medicare Part B and Part D.

Let’s break it down in a friendly and easy way.

💡 What Income Counts?

The Social Security Administration uses your adjusted gross income (AGI) from your tax return.

This includes:

Wages
Pensions
Social Security
Dividends and investments
Rental income
And other sources

📊 2025 IRMAA Income Chart

We’ve made it easy to see the monthly IRMAA charges for 2025 in the table below:

👉 Note: Your costs will depend on whether you file as a single or married couple.

✅ Check out the full 2025 IRMAA chart here — or just scroll up to see it!

📉 IRMAA Surcharges at a Glance

Here’s a helpful bar graph showing Part B surcharges based on income levels.

It shows both single and married filers so you can compare:

(Graph displayed above)

💬 Example:
If you’re married and filed taxes together with a 2023 income of $275,000, you’ll likely pay:

An extra $174.70/month for Part B
And $33.30/month for Part D

How Social Security Determines Your IRMAA

You might wonder, “How do they even know how much I made?” 🤔
Great question!

⏪ They Look Back Two Years

When the Social Security Administration determines if you owe IRMAA, they don’t use your most recent income.

Instead, they look at your tax return from two years ago.

For 2025, they use your 2023 income.
For 2024, they used your 2022 income.

This is called the look-back rule.

💼 They Use Your Tax Return (MAGI)

Social Security gets your income information directly from the IRS.

They look at something called your:

Modified Adjusted Gross Income (MAGI)

Don’t worry—it’s just your regular income plus a few extras like tax-free interest.

You don’t have to calculate it yourself—they already have it from your taxes.

🏡 Real-World Example: Raleigh, NC Couple

Let’s say Bob and Carol live in Raleigh, North Carolina.

In 2023, they sold a second home and made a profit.

That profit showed up on their taxes.

Even though they don’t usually have a high income, that one-time sale bumped up their MAGI for the year.

Now in 2025, they’re hit with IRMAA—even though their income is lower again now.

Tip: If something like this happens to you, don’t worry—there’s a way to ask Social Security to lower or remove IRMAA (we’ll explain that in the next section 😉).

IRMAA Adjustment & Appeal Process

Good news!

😊 If your income dropped recently, you might not have to pay those higher IRMAA charges—even if Social Security says you do.

If your income dropped because of a significant life event, you can appeal the IRMAA decision and ask for a lower rate.

✅ What Counts as a Life-Changing Event?

Here are some common reasons you may qualify for an IRMAA adjustment:

You retired or had your work hours cut
You got divorced
Your spouse passed away
You or your spouse lost income-producing property
You or your spouse lost a pension
You experienced a natural disaster or unexpected business loss

These are called life-changing events—exactly why the appeal process exists.

📝 How to Request an Appeal

To start the appeal process, you’ll need to fill out a simple form called:

Form SSA-44 – “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event”

You can:

Download it from the Social Security website
Visit your local Social Security office
Or call them and ask for help filling it out 📞

Include proof of your life event (like a retirement letter or death certificate).

💬 Real Example: Job Loss in Williamsburg County, SC

Take Mary, a 67-year-old from Kingstree in Williamsburg County, South Carolina.

In 2023, she was still working and had a solid income.

But in early 2024, she lost her job and fully retired.

In 2025, she gets an IRMAA notice—but her income is much lower.

Mary filled out Form SSA-44, explained her situation, and got her IRMAA charges reduced. 🙌

📌 Tip: Don’t ignore the IRMAA letter—if something has changed, take action immediately. You may save hundreds (or even thousands) of dollars annually.

Will IRMAA Affect My Medicare Advantage Plan or Medigap?

This is a prevalent question: “If I pick a different Medicare plan, can I avoid IRMAA?” 🤔

Let’s clear up the confusion.

📌 IRMAA Applies No Matter the Plan

IRMAA is an extra government charge, not your insurance company.

So whether you choose:

Original Medicare
A Medicare Advantage plan (Part C)
Or a Medigap plan (also called Medicare Supplement)

👉 IRMAA still applies if your income is above the threshold.

🏥 Medicare Advantage & IRMAA

Even though Medicare Advantage plans often include extra benefits (like dental, vision, and prescription drugs), you must still be enrolled in Medicare Part B to join one.

That means:

If you owe IRMAA, you’ll still pay the Part B surcharge
And if your plan includes prescription coverage, you may also pay the Part D surcharge

So, Medicare Advantage doesn’t cancel out IRMAA—it just wraps your coverage into one plan.

➕ What About Medigap?

Medigap plans help cover the “gaps” in Original Medicare, like deductibles and coinsurance.

They don’t include drug coverage and are not directly tied to IRMAA.

But here’s the catch:

You still have to pay for Part B
So if IRMAA applies to you, that extra charge still gets added on

💬 Example:
Let’s say Tom in Sumter, South Carolina, chooses a Medigap Plan G.

His Medigap policy isn’t affected by IRMAA, but his monthly Medicare Part B premium is.

Since his income is above the limit, he’ll pay extra monthly, no matter which company he picks.

IRMAA Examples by Region (Real Scenarios)

Sometimes, the best way to understand IRMAA is by hearing what happened to others just like you.

Here are real-world examples from across the country that show how IRMAA can apply—or be reduced—based on your situation.

🏙️ North Carolina: Rental Income in Charlotte

George, a 72-year-old retiree in Charlotte, NC, owned a small rental property.

In 2023, his tenants paid a full year of rent up front, which bumped up his reported income.

Even though George lives on Social Security and a modest pension, the extra rental income triggered IRMAA in 2025.

He was surprised by the letter but learned it was because of that one-time payment reported on his taxes.

Lesson: Even temporary income boosts can trigger IRMAA, so it’s good to be prepared.

🌆 Ohio: Retirement Appeal in Columbus

Frank and Susan, a couple from Columbus, OH, retired in late 2023. Their 2023 income was still high because they worked most of the year, so they got hit with IRMAA in 2025.

They filed Form SSA-44, explained that they had both retired, and submitted documentation.

Within a few weeks, their IRMAA charges were reduced.

Lesson: Retirement is a valid reason to appeal IRMAA, and many seniors get approved quickly.

🌴 South Carolina: Widow in Charleston

Marie from Charleston, SC lost her husband in 2023.

They had a joint income that triggered IRMAA, but by 2025, she was living on just her Social Security and a small survivor benefit.

Marie submitted her appeal with a copy of her husband’s death certificate and was granted an IRMAA exemption.

Lesson: The loss of a spouse is considered a life-changing event, and you shouldn’t have to carry that higher cost alone. 💔

🏡 Michigan: Sale of Family Farm

In Lansing, MI, Bill sold a portion of the family farmland in 2023.

While this helped his finances in the short term, it pushed his income into IRMAA territory for 2025.

He didn’t realize selling land could affect his Medicare premiums, but after speaking with an advisor, he successfully filed an IRMAA appeal.

Lesson: Selling property can lead to a temporary IRMAA, but you may be able to appeal if your income has since dropped.

🏞️ Virginia: One-Time Bonus in Roanoke

Angela, a teacher from Roanoke, VA, got a retirement bonus in 2023 when she left the school system.

That bonus raised her income for the year, and she got an IRMAA notice in 2025.

She filled out Form SSA-44, explained it was a one-time retirement payout, and approved her appeal.

Lesson: One-time payments can be appealed—especially if your current income is back to normal.

🎻 Tennessee: Divorce in Chattanooga

Leonard from Chattanooga, TN went through a divorce in 2023.

While his income used to be high, he now lives on a smaller fixed income.

The IRS still had his joint income on file, so he was hit with IRMAA.

However, after filing an appeal and explaining the divorce, his IRMAA charges were removed.

Lesson: If your household changed, IRMAA might not reflect your reality—appeal it!

How to Plan for or Avoid IRMAA in Retirement

Nobody wants surprise bills—especially in retirement.

IRMAA can feel like one of those hidden costs that sneak up on you.

But the good news is, there are smart ways to plan ahead and possibly avoid it altogether.

🧾 1. Consider Roth Conversions Before Medicare Age

If you have money in a 401(k) or traditional IRA, it counts as income when you take it out.

That could bump you into IRMAA territory.

One smart move:

Convert some of that money to a Roth IRA before you turn 65.

Why?

Roth withdrawals don’t count as income for IRMAA later on.
You’ll pay taxes on the money now, but you may avoid higher premiums later.

💰 2. Start Drawing from Retirement Accounts Early

If you’re retiring early, consider withdrawing from your 401(k) or IRA before you sign up for Medicare.

That way:

You spread out your income over more years
You reduce the chance of a “big income year” when IRMAA could kick in

Tip: This strategy works best between ages 60–64.

🏡 3. Be Mindful of Big Capital Gains

Selling a home, rental property, or investments can create large capital gains.

Even if it’s a one-time event, it can raise your income and trigger IRMAA.

You might be able to:

Spread the sale over two tax years
Use tax strategies to reduce the gain
Delay Medicare if you’re still working and covered elsewhere

🔮 4. Try IRMAA Forecasting Tools

Yes, there are tools to help you!

You can use free or paid IRMAA calculators online to estimate future premiums.

Some even let you test “what if” scenarios, like:

What if I retire at 64?
What if I sell my home in 2026?

Knowing what’s coming helps you make better decisions—and avoid costly surprises.

📌 Remember: You don’t have to go it alone.

A financial advisor or Medicare expert can walk you through the options and help you plan wisely.

Frequently Asked Questions About IRMAA

❓ Does IRMAA affect everyone on Medicare?

No.
IRMAA only affects people with higher incomes.

You’ll pay the standard Medicare premium if your income is below the threshold.

Most people on Medicare do not pay IRMAA.

❓ Is IRMAA permanent?

Not necessarily.
IRMAA is reviewed every year based on your income from two years ago.

If your income drops—due to retirement or another life event—your IRMAA could go down or even disappear the next year.

❓ Can I appeal my IRMAA surcharge?

Yes!
If you’ve had a life-changing event like retirement, divorce, or the death of a spouse, you can appeal IRMAA by filling out Form SSA-44.

Many appeals are approved quickly if you provide proper proof.

❓ Does IRMAA apply to Medigap plans?

Not directly.
IRMAA is tied to Medicare Part B and Part D—not your Medigap plan.

But since you need Part B to have Medigap, any IRMAA surcharge for Part B will still apply.

Why You Should Work With a Trusted Medicare Agency (Not a Call Center)

Let’s be honest—Medicare can be confusing.

It’s enough to make your head spin between the government letters, the surprise charges (like IRMAA), and all those phone calls from random numbers. 😵‍💫

That’s where Palmetto Mutual comes in.

🤝 Real People Who Actually Care

At Palmetto Mutual, we’re not a giant call center. We’re your local Medicare experts—real people helping real seniors.

Whether you’re in South Carolina, North Carolina, or anywhere else, we take time to explain things clearly and kindly.

When you work with us, you get:

One-on-one help from a licensed local agent
Easy-to-understand guidance on tricky topics like IRMAA
Help filing IRMAA appeals if your income changed
No pressure, no rush—just answers and support 💬

🚫 No Spam, No Telemarketers

Do you know those calls that never stop after you fill out a Medicare form online?

That’s not us.

We never:

Sell your info
Rush you into a decision
Confuse you with complicated terms

We sit down with you, answer every question, and treat you with the respect you deserve.

💻 No Need to Navigate .Gov Alone

Government websites can be overwhelming—and it’s easy to feel lost.

Instead of spending hours online trying to figure it out yourself, let Palmetto Mutual take the weight off your shoulders.

We know how to:

Interpret your IRMAA letters
Guide you through Medicare enrollment
Help you make the best choices for your budget and health needs

🌍 Proudly Serving NC, SC, and Beyond

We help seniors in places like:

Columbia, Charleston, and Sumter, SC
Charlotte, Fayetteville, and Wilmington, NC
And throughout the Carolinas and beyond

Whether face-to-face or over the phone, we’ll help you understand your coverage and feel confident in your Medicare plan.

💬 Ready to Talk?

If IRMAA confuses you—or if you just want friendly, expert help with Medicare—we’re here for you.

📞 Call Palmetto Mutual today
Or schedule a time that works for you—we’ll walk you through it, step by step.

Conclusion: Palmetto Mutual Helps You Navigate IRMAA with Confidence

Don’t let a government letter about IRMAA throw you into a panic.

You’re not the only one facing this; you don’t have to figure it out alone.

At Palmetto Mutual, we’ve helped thousands of seniors across South Carolina, North Carolina, and beyond:

Understand what IRMAA means
File appeals when income changes.
Plan smarter for retirement to avoid future IRMAA surprises

We’ll explain everything in plain English, answer every question, and ensure that you feel confident about your Medicare coverage.

So if IRMAA has you worried, let us walk you through it—step by step.

We’re local.

We’re licensed.

And we’re here for you.

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📞 Talk to a Local Agent Who Understands IRMAA. Schedule a Free Medicare Review Today!
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