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

Question

Brian Moore · Accepted 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

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.

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.

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

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

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.

Sherah Beasley · 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.

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.

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.

Steve 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 Brauer on April 14, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

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. 

Or you are welcome to email us at bkconnections@comcast.net.

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

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

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

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website