What is IRMAA?
TL:DR (AKA Too Long, Didn’t Read. As the kids say!)
IRMAA stands for Income Related Monthly Adjustment Amount
An extra premium added to your monthly Part B (possibly Part D) premium depending on your 2 year prior tax returns
IRMAA or Income Related Monthly Adjustment Amount is an added monthly premium to your Part B, sometimes Part D, based on your income. It goes off of your two year prior tax returns and can change yearly. Meaning, in 2026 it’s based on your 2024 taxes. Medicare will look at your tax returns from that year, and they do it every year, to adjust your premiums. They look at your modified adjusted gross income to make this decision and there are different brackets depending on if you file single or married. You will receive a letter in the mail directly from Social Security explaining your Original Medicare premium and if you will owe more due to IRMAA.
It does apply per person, so if you are married filing jointly, and you’re both on Medicare with a higher income, you will both owe. There is a way to appeal the IRMAA decision if you were to have a one off year of higher earnings. For example, death of a spouse, selling a business, winning the lottery, divorce, things like that. In order to appeal, you need to provide proof of the change as well as file what’s called a SSA 44 form that can be found on the Social Security website.
