Medicare IRMAA Surcharges

What is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. IRMAA is determined by Social Security using your income from two years prior — so your 2025 IRMAA is based on your 2023 tax return.

2025 Part B IRMAA brackets

The standard Part B premium is $185.00/month. IRMAA surcharges apply as follows: income $103,001–$129,000 (single) or $206,001–$258,000 (joint): total premium $259.00/month. Income $129,001–$161,000 / $258,001–$322,000: $370.00/month. Income $161,001–$193,000 / $322,001–$386,000: $480.90/month. Income $193,001–$500,000 / $386,001–$750,000: $591.90/month. Income above $500,000 / $750,000: $628.90/month.

How to appeal an IRMAA determination

If your income has decreased significantly since the tax year used to determine your IRMAA — due to retirement, divorce, death of a spouse, loss of income-producing property, or other life-changing events — you can request a new initial determination using more recent income information. File Form SSA-44 with your local Social Security office.

Strategies to reduce IRMAA

Roth conversions, qualified charitable distributions (QCDs) from IRAs, and careful timing of capital gains can help manage MAGI and reduce or avoid IRMAA surcharges. Work with a financial advisor or CPA who specializes in retirement income planning to optimize your Medicare costs.