Why am I paying more for Medicare Part B and D than my friends? What is IRMAA and how is it calculated?

Question

Sherah Beasley · Accepted Answer

If you’re paying more for Medicare Part B (medical insurance) and Part D (prescription drug coverage) than other people you know, it’s likely due to something called IRMAA – the Income-Related Monthly Adjustment Amount. 

IRMAA is an additional amount that people with higher incomes must pay on top of their standard Medicare premiums. It affects Medicare Part B and Part D. The Social Security Administration (SSA) determines if you owe IRMAA based on your reported income.

Your friends might have a lower reported MAGI, different filing statuses, or different income sources. Even similar incomes can result in different IRMAA outcomes depending on deductions, tax-exempt interest, or capital gains.

Gary Church · Answer

IRMAA means Income-Related Monthly Adjustment Amount, which applies to individuals based on the income reported for 2023. If your income was above $106,000, you will pay the IRMAA based on the higher income. You can appeal the IRMAA based on your current income with Social Security, which is going to be lower in 2025 than what you earned in 2023.

Answered by Gary Church on September 7, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Steve and Sue Brauer · Answer

IRMAA is an acronym for Income Related Monthly Adjustment Amount. It sounds like you were lucky enough to make more money than most people, two years ago. the Part B and Part D premiums are based on a "lookback" of your tax returns of 2 years ago... if you made over $212,000 as a couple of $106,000 as an individual, you will be hit with the IRMAA upcharge for that particular calendar year. The next year, its recalculated and adjusted to whatever 2 years ago tax returns show.

Answered by Steve and Sue Brauer on April 14, 2025

Broker Licensed in AZ & CA

Answered by Steve and Sue Brauer Medicare Insurance Agent

Brian Moore · Answer

When clients ask why their Medicare Part B and D premiums exceed others’, I attribute it to IRMAA, the Income-Related Monthly Adjustment Amount, which increases costs based on higher income reported on their tax return from two years prior. Medicare discourages advisors like me from quoting specific thresholds, instead directing individuals to consult the official income brackets and resources to determine their financial responsibility two years hence. The calculation uses modified adjusted gross income, and significant income events—such as a large asset sale—can elevate the surcharge, often unexpectedly impacting their total premium obligation.

Answered by Brian Moore on March 26, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent

Kelsey Hentzen · Answer

IRMA is calculated based on your adjusted gross income 2 years prior. You can find the 2026 Medicare Parts A & B Premiums and Deductibles at www.medicare.gov. If you have questions regarding IRMA, speak to your broker and they can help locate this information for you.

Answered by Kelsey Hentzen on April 20, 2026

Broker Licensed in KS & MO

Answered by Kelsey Hentzen Medicare Insurance Agent

Steven Whetstine · Answer

That is a good question, and it sounds like you already focused in on the "why!"  

IRMAA stands for Income Related Monthly Adjustment Amount and what it takes into account is your tax filings from 2 years ago.  It would be based on your Modified Adjusted Gross Income or (MAGI).  Should you fall into higher tax brackets, it could also mean that you will contribute more to Medicare costs, and this does apply to Part B (Medical) and Part D (Prescription Drug Plan) costs which can also be applied to Part C (Medicare Advantage Prescription Drug Plans).

Each year, those amounts can change.  Typically, I have found that the federal government does not release this information until November.  Once the preset brackets are adjusted and determined, the Centers of Medicare and Medicaid will release the information via tables to reflect the additional amounts you will have to pay and it could also be found on Medicare.gov.  

You would also be informed of the additional amounts added to your Part B (Medical) premiums and Part D (Prescription Drug Plan) or Part C (Medicare Advantage Prescription Drug Plans) via letter by the Social Security Administration.

James Carlson · Answer

This may be due to not earning 40 quarters.  You may be a high earner and are paying an excess premium due to higher income.

Paul Potter · Answer

IRMAA is an acronym for Income Related Monthly Adjustment Amount. It sounds like you were lucky enough to make more money than most people, two years ago. the Part B and Part D premiums are based on a "lookback" of your tax returns of 2 years ago... if you made over $212,000 as a couple of $106,000 as an individual, you will be hit with the IRMAA upcharge for that particular calendar year. The next year, its recalculated and adjusted to whatever 2 years ago tax returns show.

Answered by Steve and Sue Brauer on April 14, 2025

Broker Licensed in AZ & CA

Cody Hebden, MBA, CLU, FLMI · Answer

Congratulations! From a financial standpoint, you're reporting higher earnings on your tax returns than your friends! But in all seriousness, while Medicare Part B & D premiums are income based, the increase you may have to pay is not always permanent - as there are ways to request the Social Security Administration to re-review your assessment (ie. reduction in income, temporary income spike, etc). IRMAA is calculated based on your Modified Adjusted Gross Income (your adjusted gross income with some deductions added back in). Furthermore, how you file your taxes also play a role (ie. Single versus Married Jointly). Since the IRMAA income thresholds change every year, I highly suggest you refer directly to Medicare.gov for the specific amounts.

Answered by Cody Hebden, MBA, CLU, FLMI on August 19, 2025

Broker Licensed in NC & SC

Answered by Cody Hebden, MBA, CLU, FLMI Medicare Insurance Agent

Renee Brown · Answer

The premium for the Part B and D Medicare is based on income. The base amount for everyone is $185.00 but depending on your last 2 years income it may be more. If your friends is $185 and yours is higher, that means that your income was higher than your friends for those years.

IRMAA stands for: Income-Related Monthly Adjustment Amount, is a surcharge added to Medicare Part B and Part D premiums for those with higher incomes, calculated based on your Modified Adjusted Gross Income (MAGI) from two years prior to the current year.

Colleen Williams · Answer

IRMAA, which stands for Income-Related Monthly Adjustment Amount, is an additional fee added to your Medicare Part B and Part D premiums if your income is above a certain threshold. This surcharge is calculated based on your Modified Adjusted Gross Income (MAGI) from two years prior. IRMAA was created to ensure that higher-income beneficiaries contribute more towards their healthcare costs.

Answered by Colleen Williams on May 26, 2025

Broker Licensed in PA, FL, MD & NJ

Answered by Colleen Williams Medicare Insurance Agent

Robert Vaughan, R.Ph., MBA · Answer

You are paying more for your Medicare Part B and Part D premiums due to the Income-Related Monthly Adjustment Amount (IRMAA). IRMAA is a surcharge added to Part B and Part D premiums for those with higher incomes, based on their Modified Adjusted Gross Income (MAGI) from two years prior. You can find your MAGI on line 11 of your IRS Form 1040. The Social Security Administration (SSA) determines IRMAA amounts based on income brackets, and these brackets are adjusted annually for inflation. 

If you disagree with the Income-Related Monthly Adjustment Amount (IRMAA) that the Social Security Administration (SSA) has determined you need to pay for your Medicare Part B and/or Part D premiums, you have the right to appeal. 

How to Request a Reconsideration:
Complete and submit Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event).
Provide supporting documentation: This may include tax returns, marriage/divorce certificates, employer statements, and other evidence relevant to your specific situation.
You can contact the SSA for assistance with the reconsideration process and documentation requirements.

Shawn Brown · Answer

IRMAA is determined based on your Modified Adjusted Gross Income (MAGI) from your tax return filed two years ago.

For example, your 2025 IRMAA will be based on your 2023 tax return.

MAGI includes:

Adjusted Gross Income (AGI)

Tax-exempt interest income

Untaxed foreign income

Social Security benefits not included in AGI

Other income items that may not be taxed but count toward MAGI.

Frank Souk · Answer

IIRMA is an acronym for Income-Related Monthly Adjustment Amount. Individuals with certain income thresholds can be subject to increased Part B and Part D premiums. It is important to remember that your Medicare Part B and Part D premiums are calculated based off your Modified Adjusted Gross Income from 2 years prior.

Answered by Frank Souk on March 25, 2025

Agent Licensed in WI, AL, AR & 40 other states

Answered by Frank Souk Medicare Insurance Agent

Lady-Vienna Vedal · Answer

If you are paying more $202.90, this means that your IRMAA has increased, thus putting you in a higher income bracket.
IRMAA is Income Related Monthly Adjustment Amount.
In 2026, is IRMAA without penalty is $109,000 for single individuals and $218,000 for married couple, the calculation for Medicare Part B premium is $202.90 and Part D premium is $0.
Now, if your Medicare Part B and D premiums went up, this means that your IRMAA has increased from $109,000 to $109,001+ if single and from $218,000 to $218,001+ if married and filing jointly
Another reason your Part D premium would been up because you did not make changes during 2025 Annual Enrollment Period by exploring different plan options with lower premium.
Let me know if this is helpful.
I appreciate your questions 
 Please don't hesitate to reach out if you need my collaboration.

Steven Bleicher · Answer

This sounds like whoever you dealt with when you were about to become Medicare-eligible DID NOT TEACH you "the system" properly. Hopefully, you did use an experienced agent who was not a neophyte in the Medicare arena. IRMAA is the manner in which Medicare determines how much each Medicare member will pay for Part B (Part A is usually free). This has everything to do with your 2-year old tax return in the area of your "Adjusted Gross Income". Go to the Medicare website and put in the letters "IRMAA". This will take you to the part of the Medicare.gov site which shows you a chart. 

But, first look at your 2023 AGI and if you file individually, check that column vs. if you file with your partner, look at the column called "joint" filer. That indicates how much you'll pay in the New Year. It is also based upon the global inflation factor too, of course. As far as your Part D prescription drug plan, be sure that your agent isn't a "captive agent" since that means that she/he only works for one insurance company (ergo, a conflict of interest?). 

Dealing with an independent rep/broker is much better since she/he will note the drugs you take, the dosage and the frequency and use the Medicare.gov website to see which of the various drug plans in your State (Part D) are the best for you. Having been prescribed Brand Name Rx's (more expensive) means you'll be paying a higher monthly premium. 

However, you also have the right to use any US online pharmacy (like GoodRx.com, singlecare.com, costplusdrugs.com, etc. ) and see if their cost for the exact same drug may be less expensive for you. But, you can use ONE or the OTHER (NOT BOTH) for the same Rx): A) your Part D(rug) plan or, B) any online discount pharmacy. Note: Be aware if you use a Canadian discount pharmacy, please consider that any drug provided by that cheaper pharmacy will NOT count toward the maximum $2,000.00/year which is the most that any Medicare-eligible person will be spending for drugs in 2025 & 2026.

Steve Houchens · Answer

Your Medicare Part B premiums are based on income and may be higher in your income is over a certain amount and also may be lower if you qualify for extra help getting it paid. If you are paying higher that the standard that will be $206 a month starting 2026 but if you income drops after retirement they can look back for two years and if you income falls in line with the standard premium it can be adjusted later.

Answered by Steve Houchens on October 31, 2025

Agent Licensed in KY & TN

Answered by Steve Houchens Medicare Insurance Agent

Yasmery Vargas · Answer

The income used to determine IRMAA is your Modified Adjusted Gross Income (MAGI) It is known as your AGI plus tax-exempt interest and dividends from municipal bonds from two years ago. Your 2023 Modified Adjusted Gross Income determine your IRMAA in 2025. For 2025, if your income is $106,000 or less, your part B premium assessed would be $185.00 for 2025. If you make greater than 106,000 but less, then 133,000 Your IRMAA goes up by 74.00 making your part B premium 259.00. Refer to your social security award letter for an explanation to part B premium increase.

Answered by Yasmery Vargas on June 25, 2025

Agent Licensed in PA

Answered by Yasmery Vargas Medicare Insurance Agent

Chad Watkins · Answer

How much will I pay for my Medicare? This is a pretty typical question for anyone who is becoming eligible for Medicare. For Medicare Part A, most people will get that for free, assuming you've worked at least 40 quarters within your lifetime and paid into Social Security. If you've worked less than that, there will be a premium for Part A: $285. If you've worked 30 to 39 quarters, it's $518. If you've worked less than 30 quarters, it will be more.

For Part B, most people will pay $185 per month, but there is a sliding scale based on your income, which is known as the income-related monthly adjustment amount, or IRMAA, also known as ARMA. Depending on your income, if it's above $106,000 per year, you will pay more, which you can see on the chart here. Your Part D is very similar in that it also has an income-related monthly adjustment amount. The breakdowns are the same based on income.

These will be the amounts that you will be charged in addition to the premium you pay for your prescription drug plan. You'll also pay an additional premium for a Medicare supplement if you choose to get one, and possibly also for a Medicare Advantage plan, depending on which plan you go with. If you still have questions or need help in applying for a plan, please feel welcome to contact me.

Leslie Helene Sussman · Answer

IRMAA stands for Income-Related Monthly Adjustment amount.

IRMAA is a surcharge added to Medicare Part B and D premiums when your yearly income is above certain thresholds.

2025 Income limit for IRMAA is $106,000.00 for individuals and $212,000.00 for couples.

Income over $106k could bring your Part B premium from $259 - $628.90 plus Part D and additional $13.70 - $85.80 a month.

If your income reduces while on Medicare you can submit an appeal through Social Security.

Betty McCarty · Answer

One possible reason you are paying more than your friends could be IRMAA.

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B and Part D premiums if your income is above a certain level. Basically, people with higher incomes pay a bit more to help support the Medicare program and keep it strong for everyone.

If you have further questions, or need help navigating the Medicare terrain, please don’t hesitate to reach out to your local Medicare agent.

Tony Kiepe · Answer

The IRMA tax is based on your past two years of tax returns. High-income people pay more IRMA tax. If your income is over $106,000 for 2023, you pay an additional $74.00 for your Part B Medicare, using brackets to adjust your IRMA tax. If your income is over $133,000, you pay an additional $185.00 on top of your Part B premium. You may also pay a higher Part B premium.

Answered by Tony Kiepe on November 11, 2025

Agent Licensed in WA, AZ, ID & MT

Answered by Tony Kiepe Medicare Insurance Agent

Nicholas Ryckert · Answer

IRMAA (Income-Related Monthly Adjustment Amount) is an extra, mandatory surcharge on Part B and Part D premiums for higher-income beneficiaries, determined by the Social Security Administration. It is based on your tax return from two years prior. If your adjusted gross income is over $109,000 (Single) $218,000 (Married) you are subject to higher rates.

Answered by Nicholas Ryckert on February 24, 2026

Broker Licensed in FL, AL, AZ & 16 other states

Answered by Nicholas Ryckert Medicare Insurance Agent

Bob Callahan · Answer

IRMAA is a surchage that people w/ higher income pay on top of the base rate for Part B ($202.90 in 2026) and Part D ($0 in 2026). Income levels and respective surcharges can be found at:
 https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles.
IRMAA is based on your modified adjusted gross income (MAGI) from 2 years prior. To calculate, I default to your accountant. However, to get a good idea, add your AGI (line 11 on 1040) to your tax-exempt interest income (line 2a on 1040).
It's important to note that if your circumstances have changed from 2 years prior, and such prior income is not representative of current income then you can file form SSA-44 to lower your premiums. You should speak w/ an experienced Medicare broker or your accountant to assist.

Frank Adkisson · Answer

IRMAA = Income Related Monthly Adjustment Amount.
Bottom line:  The government believes those with higher than typical incomes can afford to pay more into the system.  There are multiple brackets you can find by doing an internet search.  The dollar amounts for IRMAA are different for single folks versus married couples.  And the brackets change annually and are adjusted for inflation.

The IRMAA is retroactive by 2 years.  So your income of 2024 (as reported on your tax return) affects an IRMAA for 2026.

Lavina Woart · Answer

It’s likely your modified adjusted gross income from two years ago is more than your friends. The income related modified adjustment amount is an extra surcharge added to your monthly Medicare part B and part D premiums if your income is above a certain amount, and the rates are determined each year by Medicare.

Answered by Lavina Woart on April 27, 2025

Agent Licensed in NY, CT, DE & FL, IA, NJ & PA

Answered by Lavina Woart Medicare Insurance Agent

Maureen Wark · Answer

IRMAA is based on someone's MAGI on their Federal tax return from 2 years prior. 
If a person or couple has income in excess of the standard amount, that person or persons will pay more for their Part B and Part D.
Each year the lookback period is 2 years prior. 
Certain circumstances are eligible for an appeal.

Vachik Chakhbazian · Answer

a surcharge added to your premiums if your income is above a certain threshold. IRMAA is calculated based on your Modified Adjusted Gross Income

Mark Boone · Answer

The IRMAA surcharge is added if your modified adjusted gross income is above a certain level. The Social Security Administration determines if you are subject to IRMAA based on your income from two years ago. For example, your 2025 IRMAA is based on your 2023 income. You can ask the SSA to reassess if you’ve had a major life-changing event.

Answered by Mark Boone on September 18, 2025

Agent Licensed in MN, FL, MI & NC, OH, SC & VA

Answered by Mark Boone Medicare Insurance Agent

Suzanne Lamperti · Answer

This is why you pay more for your Part B and Part D;

IRMMA is a Income-Related Monthly Adjustment Amount, a surcharge applied to Medicare Part B and Part D premiums for higher-income individuals. It is calculated based on your Modified Adjusted Gross Income (MAGI) from your tax return two years prior, with income thresholds determining the surcharge amount. The Social Security Administration (SSA) collects the surcharge, which can be lowered by requesting a reduction after a life-changing event, such as a job loss or death of a spouse.

Dean Chiapetto · Answer

You make more money then your friends. IRMAA = Income related Monthly Adjusted Amount. 
Once your income goes over $109,000/year for a single individual and $218,000 for a Married couple filing jointly what you pay for parts B and D of Medicare will increase.
Contact your Local Broker
Brokers Make a Difference

Todd Bostic · Answer

IRMAA is income related monthly adjusted amount, and that is if you work or have a retirement plan that is substantial. Most people don’t hit that number and it gets higher every year. You can get with your insurance agent to discuss more about how it works with you individually.

Answered by Todd Bostic on July 8, 2025

Broker Licensed in TX, AL, AZ & 12 other states

Answered by Todd Bostic Medicare Insurance Agent

Deborah Webster · Answer

If your income is over a certain threshold you may pay more for part B. IRRMA is figured on single or joint household income. For IRRMA thresholds visit ssa.gov. social security site.

Jennifer Kalbach · Answer

There are income limits to the premium paid for Part B and Part D and if you go over that limit (2 year prior tax return) then you will be assessed a surcharge. These are in increment brackets based off of income and are paid directly to Medicare.

Answered by Jennifer Kalbach on December 23, 2025

Agent Licensed in KY

Answered by Jennifer Kalbach Medicare Insurance Agent

Ben Washington · Answer

Why am I paying more for Medicare Part B and D than my friends? because premiums based on your income.
The IRMAA (Income-Related Monthly Adjustment Amount)  the premiums for Medicare Part B and Part D based on those with higher Modified Adjusted Gross Income (MAGI). It based on MAGI 2 years prior

Michael Kim · Answer

It's based on your level of income, maybe you made more money than your friends.

* IRMAA stands for Income-Related Monthly Adjustment Amount, affecting Medicare Part B and D premiums.

* It is designed to ensure higher-income beneficiaries pay more for their coverage.

* The calculation is based on your modified adjusted gross income (MAGI) from two years prior.

* The Social Security Administration (SSA) uses tax returns to determine your MAGI.

* There are specific income thresholds that trigger different IRMAA levels.
You can appeal the IRMAA determination if you experience a significant life change affecting your income.

Linda Davies · Answer

You are paying more for your Medicare Part B and Part D premiums due to the Income-Related Monthly Adjustment Amount (IRMAA). 

IRMAA is a surcharge added to Part B and Part D premiums for those with higher incomes, based on their Modified Adjusted Gross Income (MAGI) from two years prior.

Gary Haft · Answer

IRMAA is the Income Related Monthly Adjustment Amount and this changes each year and is based on your Modified Adjusted Gross Income for the last filed tax return which in many cases is the tax return from two years prior. Therefore for 2025, the tax return used is the 2023 tax return or if you have already filed your 2024 tax return, that may be used. Your income may be more than your friends and therefore you will pay more.

Answered by Gary Haft on May 26, 2025

Agent Licensed in FL, AL, DC & 9 other states

Answered by Gary Haft Medicare Insurance Agent

Ken Banks · Answer

You are likely paying more for Medicare Parts B and D than your friends because your income exceeds specific thresholds, triggering the Income-Related Monthly Adjustment Amount (IRMAA) surcharge. IRMAA is an extra fee added to premiums for beneficiaries with higher incomes, based on data from your tax return two years prior.

Answered by Kristin Ingram on March 16, 2026

Broker Licensed in FL, AZ & CA

Answered by Kristin Ingram Medicare Insurance Agent

John Messler · Answer

Medicare participants with an income above the threshold must pay a surcharge based on their income. IRMAA is the calculation of the surcharge for people that have earnings above 100k for an individual or 200k for a couple. So your earning history was higher than your friends. The IRMAA increase are capped at income of 500 K per individual and 750 K per couple.

Answered by John Messler on September 26, 2025

Agent Licensed in NH, ME, NC, OH, PA & TX

Answered by John Messler Medicare Insurance Agent

Dominic Javier · Answer

If you find yourself paying more for Medicare Part B and D than your friends, it’s likely due to the Income-Related Monthly Adjustment Amount (IRMAA). This adjustment affects the premiums of those with higher incomes.

Answered by Dominic Javier on November 5, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Patrick Stinson · Answer

IRMAA, or the Medicare Income-Related Monthly Adjustment Amount, is a surcharge on Medicare Part B and Part D premiums for individuals with higher incomes. It is calculated using your Modified Adjusted Gross Income (MAGI) from two years prior, which the Social Security Administration (SSA) determines using IRS tax data. The SSA then uses this MAGI to place you into an income bracket, which determines how much your premium will increase. 
How IRMAA is calculated
Based on MAGI: The calculation starts with your Modified Adjusted Gross Income (MAGI), which is your Adjusted Gross Income (AGI) plus tax-exempt interest.
Two-year lookback: The income used is from two years before the current year. For example, your 2025 IRMAA is based on your 2023 tax return.
Income brackets: The SSA uses statutory tables to place your MAGI into a specific bracket based on your tax filing status (e.g., single or married filing jointly).
Premium adjustment: The higher your income bracket, the higher the IRMAA surcharge you will pay on top of the standard premium for Part B and/or Part D.
Life-changing events: You can appeal for an IRMAA reduction or removal if a "life-changing event" has significantly lowered your income. You can file Form SSA-44 to report this.

Jermaine Williams · Answer

IRMAA stands for Income-Related Monthly Adjustment Amount which is an additional charge on top of the standard Medicare Part B and Part D premiums for those with higher incomes. So depending on your tax-bracket that may be the reason why you're paying more in premiums

Answered by Jermaine Williams on October 2, 2025

Broker Licensed in TX, AL, AR & 12 other states

Answered by Jermaine Williams Medicare Insurance Agent

Jajuan Knox · Answer

If you’re paying more for Medicare Part B and Part D than your friends, it’s usually because of something called IRMAA  which stands for Income Related Monthly Adjustment Amount.

IRMAA is an additional premium added to your Medicare Part B and Part D if your income is above certain limits. Medicare looks at your tax return from two years ago to determine this. So for example, your 2026 premiums are based on your 2024 income.

It’s based on your Modified Adjusted Gross Income (MAGI), which includes things like:

Wages

Social Security (taxable portion)

Pension income

Capital gains

Required Minimum Distributions (RMDs)

Investment income

If your income crosses certain thresholds, you move into a higher bracket and pay more.

The good news is, IRMAA isn’t permanent. If your income drops due to retirement, loss of income, death of a spouse, or other qualifying life events, we can file an appeal to potentially lower your premium.

This is why income planning and Medicare planning really go hand in hand small income decisions can impact your premiums significantly.

Richard Norcross · Answer

If you are paying more for your Part B and Part D it is likely because of IRMAA.
IRMAA is the Income Related Monthly Adjustment Amount and is calculated by income levels with a 2 year look back.

Mark Davisson · Answer

Your income must be higher than the average household as Part B recipients pay differing amounts if their income is higher. I believe there are four brackets for this with each income increase rendering an increase in your Part B premium.

Answered by Mark Davisson on January 12, 2026

Agent Licensed in VT, FL, KS, ME, MI & NC

Answered by Mark Davisson Medicare Insurance Agent

Ana V. Magalhaes · Answer

Hi, IRMAA is the Medicare Income-Related Monthly Adjustment Amount, an extra surcharge added to Part B and Part D premiums for high-income beneficiaries, determined by the Social Security Administration based on tax returns from two years prior.

You may want to refer to Medicare.gov for more information.

Tanja Roulhac · Answer

Why Are You Paying More for Medicare Part B and D?
It's common for Medicare premiums to vary between individuals, and one key reason is your income level. While most people pay the standard premiums for Part B and Part D, higher-income earners may face additional charges. Let me break this down for you, including what IRMAA is and how it's calculated.

Reasons You Might Be Paying More
Income-Based Surcharges (IRMAA): If your modified adjusted gross income (MAGI) is above certain thresholds, you'll pay an extra amount called the Income-Related Monthly Adjustment Amount (IRMAA). This is often why you might pay more than friends with lower incomes.

Other Factors: Differences could also stem from plan choices (e.g., if you're in a more comprehensive Part D plan), location-based adjustments, or late enrollment penalties. However, IRMAA is the most likely culprit for income-related increases.

What is IRMAA and How is It Calculated?
IRMAA is an additional fee added to your Medicare Part B and Part D premiums if your income exceeds IRS and CMS thresholds. It's designed to make higher-income beneficiaries contribute more toward their healthcare costs.

How It's Calculated:
Based on Income: IRMAA uses your MAGI from your federal tax return two years prior (e.g., 2025 premiums are based on your 2023 tax return).

MAGI Definition: This includes your adjusted gross income plus tax-exempt interest, foreign income, and certain deductions.

Thresholds and Surcharges: CMS sets income brackets annually. For 2025, here's a simplified breakdown based on filing status (using 2023 MAGI):


Filing Status	Income Threshold for IRMAA	Part B Surcharge (Added to Standard Premium)	Part D Surcharge (Added to Plan Premium)
Individual	$103,000 or less: No IRMAA	N/A	N/A
$103,001–$161,000	+$69.90/month	+$12.70/month
$161,001–$193,000	+$174.70/month	+$32.80/month
$193,001–$228,000	+$279.00/month	+$52.80/month
$228,001+	+$383.00–$419.00/month (varies by bracket)	+$72.90–$79.70/month (varies by brack

Brian Loquist · Answer

IRMAA Iis based on your income from 2 years proir. It will adjust your Part B and Part D premiums based on how much you make.

Doris Youngman · Answer

IRMAA is based on your annual income. If it is higher than the normal income, you pay a higher premium for IRMAA every month. How is IRMAA calculated, I don't know.

Tony Carlton · Answer

That's a wonderful point. Thank you for the opportunity to clarify an under-covered subject.
You have been hit with an extra charge because of your annual taxable income from the last 2 years. Medicare Part B {commonly called, doctor coverage} and Medicare Part D {Prescription Drug coverage} premiums are increased at 5 different thresholds that determine your premium increase {penalty}. The increase is based on your Modified Adjusted Gross Income {MAGI}  Bracket and that determines the Part B & Part D Surcharge.

For Individuals the range is:

Individual
$106,000.01 - $133,000
$74.00 (Part B) + $13.70 (Part D)
Individual
$133,000.01 - $167,000
$185.00 (Part B) + $35.30 (Part D)
Individual
$167,000.01 - $200,000
$295.90 (Part B) + $57.00 (Part D)
Individual
$200,000.01 - $499,999.99
$406.90 (Part B) + $78.60 (Part D)
Individual
More than $499,999.99
$443.90 (Part B) + $85.80 (Part D)


For Married couples who file jointly the range is:

Married Filing Jointly
$212,000.01 - $266,000
$74.00 (Part B) + $13.70 (Part D)
Married Filing Jointly
$266,000.01 - $334,000
$185.00 (Part B) + $35.30 (Part D)
Married Filing Jointly
$334,000.01 - $400,000
$295.90 (Part B) + $57.00 (Part D)
Married Filing Jointly
$400,000.01 - $749,999.99
$406.90 (Part B) + $78.60 (Part D)
Married Filing Jointly
More than $750,000
$443.90 (Part B) + $85.80 (Part D)

If I may ask and answer your unasked question...  Is IRMAA avoidable?

To avoid IRMAA there is nothing you can do to reduce it immediately. This is so because there is a 2 year "Look-back" on your MAGI. So, with proper planning you may be able to avoid the IRMAA in 2 years and beyond. Most Medicare agents don't know how to avoid IRMAA and most Financial Advisors know nothing about Medicare. You'll need to reach out to an expert  who knows how both lanes can merge together for your benefit.

Remember, there is a good and honorable solution for every good thing under the Sun.
Again, thanks for that under-asked question and God bless!

Kristin Ingram · Answer

You are likely paying more for Medicare Parts B and D than your friends because your income exceeds specific thresholds, triggering the Income-Related Monthly Adjustment Amount (IRMAA) surcharge. IRMAA is an extra fee added to premiums for beneficiaries with higher incomes, based on data from your tax return two years prior.

Answered by Kristin Ingram on March 16, 2026

Broker Licensed in FL, AZ & CA

George Barkley · Answer

The only reason for having a higher Medicare Part B or Part D premium would be if you had a high income (according to the government) in any of the past two years. There is a 2 year look back that they use to check a beneficiary's income. So for 2026 calculations, they would look back at income for 2024 and 2025. If you are over certain thresholds, you'll have an extra amount you'll have to pay for your Medicare premiums.

Answered by George Barkley on March 9, 2026

Broker Licensed in GA, AL, FL & NC, SC, TN & TX

Answered by George Barkley Medicare Insurance Agent

Karri Todd · Answer

Income related monthly adjusted amount! Talk to your financial planner or social security office! Best wishes to you!

Joseph Smith · Answer

You are paying more for Medicare Part B and D than your friends because of your income. IRMAA is an income related monthly adjustment that applies to Medicare Part B and D. The IRMAA is calculated based on your tax return from 3 years prior.

Answered by Joseph Smith on May 12, 2025

Agent Licensed in SC, MD & NC

Answered by Joseph Smith Medicare Insurance Agent

Roarke Andrews · Answer

The IRMAA is calculated based upon a previous year's tax filing.  Depending on your tax filing status and income, you may be subject to the additional IRMAA fee.

Why am I paying more for Medicare Part B and D than my friends? What is IRMAA and how is it calculated?

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Why am I paying more for Medicare Part B and D than my friends? What is IRMAA and how is it calculated?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

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Agent Locator

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A non-government resource website