Some Medicare beneficiaries are surprised to learn that their Part B and Part D premiums can be higher than the standard rate if their income exceeds certain thresholds. These additional charges are known as Income-Related Monthly Adjustment Amounts (IRMAA). While they can feel frustrating, you may have the right to appeal them.
At Carolina Senior Benefits, we’ve helped many clients navigate the IRMAA process and successfully lower their premiums. Here’s everything you need to know about how IRMAA works and how to file an appeal if you believe your income no longer reflects your current financial situation.
What Is IRMAA and How Does It Affect Your Medicare Costs?
For most new Medicare enrollees in 2026, the standard Part B premium is $202.90 per month. However, individuals with higher incomes may pay more than this base amount.
Your premium is determined by the Social Security Administration (SSA) using your Modified Adjusted Gross Income (MAGI) from your federal tax return, typically from two years prior. So, your 2026 premiums are usually based on the income reported on your 2024 tax return.
If your income exceeds certain limits, the SSA adds an IRMAA surcharge to your Part B and Part D premiums. These extra costs are either deducted from your Social Security benefits or billed directly if you’re not yet receiving benefits.
If you believe your current income is significantly lower due to a major life event, you can request a reconsideration by filing an IRMAA appeal
Understanding Your Modified Adjusted Gross Income (MAGI)
Your MAGI is your Adjusted Gross Income (AGI) plus any tax-exempt interest income. It includes earnings such as:
- Wages or self-employment income
- Dividends and investment income
- Capital gains
- Rental or farm income
- Alimony received
- Taxable Social Security benefits
It’s important to note that your MAGI does not reflect your current income if your situation has changed recently, especially after retirement. This is why some beneficiaries end up paying a higher Medicare premium temporarily.
When You Can Appeal an IRMAA Decision
The SSA allows IRMAA appeals if you’ve experienced a “life-changing event” that has reduced your income. The most common qualifying events include:
- Retirement or reduction in work hours
- Marriage, divorce, or death of a spouse
- Loss of income-producing property
- Reduction or loss of a pension
- Employer settlement or company closure
For example, imagine you earned $110,000 in 2024 while working but retired in 2025, and now your annual income has dropped to $45,000 from Social Security and IRA withdrawals. Even though SSA may base your 2026 premiums on your higher 2024 income, you can appeal by showing your current income is much lower due to retirement.
If your appeal is successful, your premium will be adjusted to reflect your updated financial circumstances.
How to File an IRMAA Appeal
To begin your appeal, you’ll need to complete Form SSA-44, called the “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event” form.
This form walks you through reporting your life event, calculating your current income, and listing the documents you’ll need to provide. You can find it on the Social Security Administration’s website or request a copy from your local office.
Strong documentation is key.
Include a clear cover letter explaining why you believe your IRMAA is incorrect and attach evidence that supports your claim. Depending on your situation, that might include:
- A retirement or termination letter from your employer
- Recent pay stubs showing the end of wages
- Bank statements or investment records showing reduced income
- Pension or benefit statements confirming changes
The more official proof you provide, the stronger your case will be.
If Social Security agrees with your appeal, your premium will be adjusted automatically. If they deny your request, you’ll receive instructions on how to escalate the appeal to an Administrative Law Judge.
Important Note: You must continue paying your higher premium while your appeal is under review. If it’s approved, any overpaid amounts will typically be credited toward future premiums rather than refunded directly.
How IRMAA Impacts Your Medicare Part D Premium
IRMAA doesn’t just apply to Part B – it can also increase your Part D (prescription drug coverage) premium.
Unlike Part B, Part D premiums vary by plan and location, but the IRMAA surcharge is added on top of your regular plan premium. For 2026, Part D premiums can range from around $7 to over $180 per month, depending on the plan and region.
For example, if your plan’s monthly premium is $30 and you owe an IRMAA surcharge, that adjustment will be added to your premium total. The IRMAA portion is paid directly to Medicare and often deducted from your Social Security check or billed separately.
Failing to pay this extra amount could result in your Part D coverage being terminated, so it’s important to stay current on all payments.
What Happens After Your Appeal
Every year, Social Security reviews your most recent tax information and automatically adjusts your IRMAA if your income has gone down. Beneficiaries typically receive a notice in December or January detailing any changes for the new year.
If your income consistently remains below the IRMAA threshold, your higher premium should eventually be removed without any further action.
That said, if you know in advance that your income will drop (for example, when you retire or reduce work hours), you can plan ahead. A financial planner can help you time your retirement account withdrawals and manage your income flow to minimize IRMAA exposure.
Managing Medicare Costs Beyond Your Premium
Once your Medicare premiums are squared away, you can explore ways to save on supplemental coverage. Many higher-income individuals find that certain Medigap (Medicare Supplement) plans help offset costs while maintaining flexibility in care.
For instance:
- Plan G covers nearly all Medicare-approved expenses except for the annual Part B deductible ($283 in 2026). Its lower premium—often up to $250 less than Plan F—makes it a strong value choice.
- Other plans like Plan N, Plan L, Plan M, and High Deductible Plan G or F can also reduce monthly costs in exchange for a bit more cost-sharing.
These plans can be especially smart options for people who can comfortably handle occasional out-of-pocket costs but want to keep their ongoing premiums low.
Get Help with Your IRMAA Appeal and Medicare Planning
If you’ve been notified of a higher Medicare premium due to your income, don’t assume you’re stuck with it. You may qualify for a reduction through an IRMAA appeal, and our team can guide you through each step.
At Carolina Senior Benefits, we help clients understand their Medicare costs, explore appeal options, and find supplemental coverage that fits their budget and health needs.
Contact us today for a free consultation and see how we can help you make the most of your Medicare benefits.
