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.

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

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.

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

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 at 1-800-772-1213 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.

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.

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

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.

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, DE, IA, NJ & PA

Answered by Lavina Woart Medicare Insurance Agent

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

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

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.

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

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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