Not everyone has the same premium for their Medicare Part B Insurance. The Centers for Medicare and Medicaid Services (CMS) sets a standard premium each year, which is what the majority of beneficiaries pay. However, about 8% of people actually pay a higher premium for both Medicare Part B and Medicare Part D.
The higher premium is called IRMAA, which stands for Income-Related Monthly Adjustment Amount. Depending on your income, your Medicare premiums could be increased significantly. Unfortunately, many people don’t realize they’re subject to IRMAA until they get a letter from Social Security notifying them of their new premium or they see a larger amount deducted from their Social Security check.
How IRMAA is Calculated
IRMAA is calculated based on your modified adjusted gross income on your prior two years tax return. So, for 2025 Medicare Part B and Part D premiums, Social Security will be looking at your 2023 tax return. If Social Security determines that you are required to pay a higher than standard rate for Medicare premiums, you will receive a letter from Social Security with the amount of your premiums and an explanation.
Each year CMS publishes the standard rates for Medicare Part B as well as a chart for IRMAA levels. The IRMAA chart includes costs for Medicare Part B and Part D. Even if you are enrolled in a $0 premium Medicare Advantage Plan or Part D Prescription Drug Plan, you will have a premium based on your Part D IRMAA.
Qualified Events for Medicare Premium Appeals
If you experience a qualifying life event, you may be able to appeal your IRMAA calculation. Qualifying events are life-changing events that impact your income, including:
- Marriage, divorce, or the death of a spouse
- Changes or termination of a pension
- Losing an income-producing property
- Receiving a settlement from an employer due to company bankruptcy or closure
- Retirement or work stoppage events.
You can also appeal your Medicare IRMAA if you feel the MAGI on your tax return is incorrect. However, this is a situation that will require a bit more work as you’ll have to contact the IRS to correct the information prior to beginning the appeal process.
How to File Your Appeal
If you think you may be eligible to appeal your IRMAA, there is a specific process to do so.
- Step 1: Print Form SSA-44: Medicare Income-Related Monthly Adjustment Amount-Life-Changing Event. This form will walk you through the entire appeal process and list the documentation you’ll need in order to file the request.
- Step 2: Fill out the form and attach copies of all the required documentation. Provide as many official documents as you can. Make sure to sign the form and make a copy for your records.
- Step 3: Submit your appeal. You may submit your appeal by faxing or by dropping it at your local Social Security office. You may also schedule an appointment at your local social security office.
Need Help Navigating IRMAA or Medicare?
If you’re unsure about your IRMAA or need assistance navigating your Medicare premiums and potential appeals, our United Benefits Medicare Specialists are here to help. Fill out the form below to get started.