Are IRMAA Brackets Adjusted for Inflation? (w/Examples) + FAQs

Yes, IRMAA brackets are adjusted for inflation each year. The Social Security Administration uses the Consumer Price Index for All Urban Consumers (CPI-U) to recalculate the first four income brackets annually. The fifth and highest bracket, created by the Bipartisan Budget Act of 2018, is frozen and cannot be adjusted for inflation until at least 2028.

The governing statute behind IRMAA is the Medicare Modernization Act of 2003 (codified at 42 U.S.C. § 1395r), which requires higher-income Medicare beneficiaries to pay more than the standard premium. Because IRMAA uses a two-year look-back on your tax returns, many retirees get blindsided by a surcharge they never saw coming. According to a Medicare Trustees Report, only about 7% of Medicare Part B beneficiaries currently pay IRMAA — but the surcharge can add nearly $10,000 per year to your Medicare costs.

Here is what you will learn in this article:

  • 📊 How the CPI-U inflation formula actually adjusts IRMAA brackets each year
  • 💰 The exact 2025 and 2026 IRMAA brackets for Part B and Part D — plus how they compare
  • 🏠 Three real-world scenarios showing how a home sale, Roth conversion, or retirement income spike can trigger IRMAA
  • 📝 How to appeal IRMAA using Form SSA-44 and the qualifying life-changing events that make you eligible
  • 🛡️ Proven strategies to reduce or avoid IRMAA — including Roth conversions, QCDs, and income timing

What IRMAA Actually Is and Who It Hits

IRMAA stands for Income-Related Monthly Adjustment Amount. It is a monthly surcharge added on top of the standard Medicare Part B and Part D premiums for beneficiaries whose income exceeds certain thresholds. The Social Security Administration (SSA) determines who pays IRMAA based on your Modified Adjusted Gross Income (MAGI) from two years prior.

IRMAA applies to everyone enrolled in Medicare — whether you have Original Medicare or a Medicare Advantage plan. In 2026, the standard monthly Part B premium is $202.90 per person. If your income pushes you into the highest IRMAA bracket, that premium jumps to $689.90 per month — more than three times the standard rate.

The surcharge operates on a sliding scale with five income brackets. Each bracket requires you to pay a higher percentage of the total program costs. The theory is straightforward: if you earn more, you can afford to contribute more toward Medicare.

IRMAA BracketYour Share of Program Costs
No IRMAA (standard)25%
Bracket 1 (1.4x)35%
Bracket 2 (2.0x)50%
Bracket 3 (2.6x)65%
Bracket 4 (3.2x)80%
Bracket 5 (3.4x)85%

A beneficiary in Bracket 5 pays 3.4 times the standard premium. For a married couple where both spouses are on Medicare, that surcharge applies to each person — doubling the hit.

The Federal Law Behind IRMAA’s Inflation Adjustment

IRMAA was created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). A Republican Congress under President George W. Bush passed it in November 2003. The law went into effect in 2007, when the first IRMAA brackets were implemented.

Two major legislative changes reshaped IRMAA after its creation. In 2010, the Affordable Care Act (ACA) under President Obama expanded IRMAA to include Medicare Part D — meaning higher-income beneficiaries now paid surcharges on prescription drug coverage too. Then in 2018, the Bipartisan Budget Act under President Trump added a fifth IRMAA bracket for the wealthiest beneficiaries.

That fifth bracket came with a catch. The law stipulated that the $500,000 (single) and $750,000 (joint) thresholds would not be adjusted for inflation until at least 2028. This means inflation gradually pushes more people into that top bracket each year, even if their real purchasing power hasn’t changed.

IRMAA has become a bipartisan consensus. Congresses and administrations from both parties have left its core structure untouched for over 20 years. There is no current push for major reform.

How the CPI-U Inflation Formula Works

The first four IRMAA brackets are indexed to inflation each year using a specific formula tied to the CPI-U. Understanding this formula helps you predict where brackets will land in future years — and plan your income accordingly.

The SSA compares the average CPI-U over the 12-month period ending in August of the current year to the average CPI-U from a base period (September 2017 through August 2018, where the average was 249.280). The resulting ratio is then applied to the base-year brackets to calculate the new thresholds.

Each bracket threshold is then rounded to the nearest $1,000 for single filers. Joint filer thresholds are double the single filer amount. The SSA announces the new brackets in the fall (typically October or November), and they take effect the following January.

CPI-U Formula StepWhat Happens
Collect monthly CPI-U dataSeptember through August of the current year
Calculate 12-month averageAdd all 12 monthly CPI-U values, divide by 12
Compare to base periodDivide current average by 249.280 (base period average)
Apply ratio to base bracketsMultiply base-year income thresholds by the ratio
Round to nearest $1,000Final bracket number for single filers

This averaging method creates an important nuance. Even if prices stop rising entirely, the brackets can still increase the following year. That’s because the average of 12 months at a stable higher price will still exceed the average of the prior 12 months when prices were climbing. This is why IRMAA brackets estimated at 0% future inflation can still show small increases.

For 2026, the IRMAA brackets increased by approximately 3% compared to 2025. The CPI-U data used for 2026 brackets showed an adjustment of roughly 1.04%, but bracket rounding and cumulative averaging produced the slightly larger effective increase.

The Complete 2026 IRMAA Brackets for Medicare Part B

Your 2026 IRMAA is based on your 2024 MAGI (the tax return you filed in 2025). The standard Part B premium is $202.90 per month — a 9.7% increase from the 2025 premium of $185.00. Medical costs tend to outpace general inflation, and 2026 is no exception.

Single Filers: Part B Monthly Premiums

2024 MAGI (Single)Total Monthly Part B Premium
$109,000 or less$202.90 (standard — no surcharge)
$109,001 – $137,000$284.10 ($81.20 surcharge)
$137,001 – $171,000$405.80 ($202.90 surcharge)
$171,001 – $205,000$527.50 ($324.60 surcharge)
$205,001 – $499,999$649.20 ($446.30 surcharge)
$500,000 or more$689.90 ($487.00 surcharge)

Joint Filers: Part B Monthly Premiums

2024 MAGI (Joint)Total Monthly Part B Premium
$218,000 or less$202.90 (standard — no surcharge)
$218,001 – $274,000$284.10 ($81.20 surcharge)
$274,001 – $342,000$405.80 ($202.90 surcharge)
$342,001 – $410,000$527.50 ($324.60 surcharge)
$410,001 – $749,999$649.20 ($446.30 surcharge)
$750,000 or more$689.90 ($487.00 surcharge)

Married couples who file separately face a much narrower bracket structure. If you file separately and earn above $109,000, you jump directly to the 3.2x premium ($649.20/month) — skipping the lower surcharge tiers entirely.

2026 IRMAA Brackets for Medicare Part D

Medicare Part D covers prescription drugs. The IRMAA income brackets for Part D are identical to Part B, but the surcharge amounts are lower. The average standard Part D premium for 2026 decreased to $38.99 per month.

Part D premiums vary by state and plan, so your actual premium may differ. The IRMAA surcharge is added on top of whatever your plan charges.

2024 MAGI (Single / Joint)Part D Monthly Surcharge
$109,000 / $218,000 or less$0.00 (no surcharge)
$109,001–$137,000 / $218,001–$274,000+$14.50
$137,001–$171,000 / $274,001–$342,000+$37.50
$171,001–$205,000 / $342,001–$410,000+$60.40
$205,001–$499,999 / $410,001–$749,999+$83.30
$500,000+ / $750,000++$91.00

At the highest bracket, a single person pays up to $487.00 extra for Part B plus $91.00 extra for Part D — a combined IRMAA surcharge of $578.00 per month or $6,936 per year. For a married couple both on Medicare, double that to nearly $13,872 per year.

How 2025 and 2026 IRMAA Brackets Stack Up

The brackets shift every year because of inflation indexing. Comparing 2025 to 2026 reveals exactly how much the thresholds moved.

Bracket (Single / Joint)2025 Threshold2026 Threshold
Bracket 1 (Single)$106,000$109,000
Bracket 1 (Joint)$212,000$218,000
Bracket 2 (Single)$133,000$137,000
Bracket 2 (Joint)$266,000$274,000
Bracket 3 (Single)$167,000$171,000
Bracket 3 (Joint)$334,000$342,000
Bracket 4 (Single)$200,000$205,000
Bracket 4 (Joint)$400,000$410,000
Bracket 5 (Single)$500,000$500,000 (frozen)
Bracket 5 (Joint)$750,000$750,000 (frozen)

The first four brackets each rose by $3,000 to $10,000 depending on the filing status. The fifth bracket stayed exactly the same — it has been locked at $500,000/$750,000 since 2018 and won’t move until at least 2028.

The Frozen 5th Bracket: A Hidden Tax Trap

The Bipartisan Budget Act of 2018 created the highest IRMAA tier with income thresholds of $500,000 (single) and $750,000 (joint). Congress intentionally froze these thresholds and prohibited inflation adjustments until 2028.

This freeze functions as a stealth tax increase. Every year that inflation rises while the bracket stays flat, more people cross the $500,000 or $750,000 line in nominal dollars — even though their purchasing power hasn’t actually grown. A person earning $480,000 in 2018 who received cost-of-living salary increases could now be above $500,000 without any real income growth.

The consequence is severe. Beneficiaries in the 5th bracket pay 3.4 times the standard premium — the maximum IRMAA surcharge. For 2026, that means $689.90 per month for Part B alone, plus up to $91.00 for Part D. There is no higher bracket above this, so whether you earn $500,001 or $5,000,000, you pay the same surcharge.

The Two-Year Look-Back That Catches People Off Guard

IRMAA uses your MAGI from two years ago to set your current premiums. Your 2024 tax return determines your 2026 IRMAA. Your 2025 tax return determines your 2027 IRMAA. This two-year lag exists because CMS determines IRMAA charges in the 4th quarter of each year, and the most recent completed tax return available at that point is from two years prior.

This creates a painful timing problem. If you had a one-time income spike two years ago — from selling a house, receiving a large bonus, or doing a major Roth conversion — you could face IRMAA surcharges today even though your current income is much lower.

The SSA sends you a letter informing you of your IRMAA surcharge. By the time you receive it, it’s too late to make any changes to the income from two years ago. The only options at that point are to pay the surcharge or file an appeal using Form SSA-44 if you have a qualifying life-changing event.

Two-Year Look-BackIncome Year Used
2026 IRMAA determination2024 MAGI
2027 IRMAA determination2025 MAGI
2028 IRMAA determination2026 MAGI

What Counts as MAGI for IRMAA (and What Doesn’t)

Your Modified Adjusted Gross Income for IRMAA purposes is not the same as MAGI used for other tax calculations. The IRMAA-specific MAGI is your Adjusted Gross Income (Form 1040, Line 11) plus tax-exempt interest income (Form 1040, Line 2a).

Tax-exempt interest includes interest from municipal bonds, tax-exempt dividends, and interest from U.S. Savings Bonds used for qualified higher education expenses. This add-back is a common trap — many retirees invest in municipal bonds thinking they’re completely tax-free, only to discover the interest pushes them over an IRMAA threshold.

Here’s what is included in MAGI for IRMAA:

Income SourceIncluded in IRMAA MAGI?
Wages, salaries, and self-employment incomeYes
Taxable Social Security benefitsYes
Traditional IRA/401(k) distributionsYes
Roth conversion amountsYes
Capital gainsYes
Pension and annuity incomeYes
Rental incomeYes
Municipal bond interest (tax-exempt)Yes (added back)
Untaxed Social Security benefitsNo
Qualified Roth IRA withdrawalsNo
HSA withdrawals for medical expensesNo

One critical distinction: the MAGI for IRMAA includes only the taxable portion of Social Security benefits, not the untaxed portion. If you see guidance elsewhere claiming that all Social Security income counts toward IRMAA, that’s referring to a different definition of MAGI — such as the one used for ACA marketplace subsidies.

The Cliff Effect: How $1 Can Cost You Thousands

IRMAA is a cliff-based surcharge, not a gradual one. If your income lands even $1 above a bracket threshold, you owe the full surcharge for that bracket — not a proportional amount. There is no phase-in or sliding calculation within a bracket.

Consider a single filer in 2026 who has a MAGI of exactly $109,001. That single dollar above the threshold triggers an IRMAA surcharge of $81.20 per month — or $974.40 per year. For a married couple where both spouses are on Medicare, $1 over the joint threshold of $218,000 results in a combined hit of $1,948.80 per year.

This cliff effect makes precise income management essential. Retirees must watch their MAGI carefully, especially in December when there’s still time to adjust Roth conversion amounts, realize capital gains, or make charitable contributions.

Scenario 1: Linda Sells Her Home and Triggers IRMAA

Linda is a 67-year-old single retiree living in Arizona. Her typical annual MAGI is around $95,000, which keeps her well below the IRMAA threshold. In 2024, she sold her home and realized a $250,000 capital gain after applying the $250,000 single-filer home sale exclusion.

Her 2024 MAGI jumped to $345,000 — putting her in the third IRMAA bracket. Two years later, in 2026, Linda receives a letter from the SSA informing her of the surcharge.

What HappenedIRMAA Consequence
Linda’s normal MAGI: $95,000No IRMAA — standard $202.90/month Part B premium
2024 home sale adds $250,000 capital gain2024 MAGI jumps to $345,000
MAGI of $345,000 falls in Bracket 3 (single)Part B premium: $527.50/month ($324.60 surcharge)
Part D surcharge also applies+$60.40/month added to Part D premium
Total extra cost for 2026$4,620/year in IRMAA surcharges

Linda had no idea the home sale would affect her Medicare premiums two years later. She could have reduced her exposure by spreading the sale across two tax years, offsetting gains with tax-loss harvesting, or making a large charitable donation in the same year.

Scenario 2: Robert Does a Large Roth Conversion

Robert is a 66-year-old married retiree filing jointly with his wife Susan. Their combined MAGI is typically $200,000. In 2024, Robert converted $100,000 from his Traditional IRA to a Roth IRA to reduce future Required Minimum Distributions (RMDs).

That conversion pushed their 2024 MAGI to $300,000 — well into the second IRMAA bracket for joint filers. Both Robert and Susan are on Medicare, so each of them pays the surcharge.

What HappenedIRMAA Consequence
Normal combined MAGI: $200,000No IRMAA — each pays $202.90/month for Part B
$100,000 Roth conversion in 20242024 MAGI rises to $300,000
MAGI of $300,000 falls in Bracket 2 (joint)Each pays $405.80/month for Part B ($202.90 surcharge each)
Part D surcharge also applies per person+$37.50/month per person for Part D
Total extra cost for 2026 (both spouses)$5,769.60/year in combined IRMAA surcharges

Robert’s strategy of reducing future RMDs was sound, but the execution was flawed. A better approach would be to spread Roth conversions over several years at smaller amounts, staying just below the next IRMAA bracket. Converting $18,000 per year instead of $100,000 at once would have kept their MAGI under $218,000 and avoided IRMAA entirely.

Scenario 3: Maria and James Face the Widow Penalty

Maria and James are a married couple, both 72, filing jointly. Their combined MAGI from Social Security, pensions, and RMDs is $215,000 — just below the 2026 joint threshold of $218,000. They pay no IRMAA.

James passes away in 2025. Maria’s income only drops by James’s Social Security benefit of approximately $25,000. Her new MAGI is around $190,000. She now files as single, and the single-filer IRMAA threshold is just $109,000.

What HappenedIRMAA Consequence
Joint MAGI of $215,000 (both alive)Below $218,000 threshold — no IRMAA
James passes away in 2025Maria now files as single
Maria’s new MAGI: $190,000Falls in Bracket 3 for single filers ($171,001–$205,000)
New Part B premium for Maria$527.50/month ($324.60 surcharge)
Total extra cost per year$4,620/year in IRMAA surcharges

This is called the “widow penalty.” Maria’s income barely dropped, but her filing status changed — cutting her IRMAA threshold roughly in half. She can file an appeal using Form SSA-44 citing “death of a spouse” as a life-changing event. If approved, the SSA will use her current-year income instead of the two-year look-back. She may get a one-year pass, but after that, she will be assessed as a single filer going forward.

Proven Strategies to Reduce or Avoid IRMAA

Lowering your Modified Adjusted Gross Income is the most effective way to avoid or reduce IRMAA. Because the surcharge uses a two-year look-back, every dollar you reduce today affects your premiums two years from now.

Strategic Roth Conversions

Converting Traditional IRA funds to a Roth IRA increases your MAGI in the year of conversion but permanently lowers your taxable income in later years. Qualified Roth withdrawals are not included in MAGI. The key is to spread conversions over several years in smaller amounts, keeping your MAGI just below the next IRMAA threshold each year.

Converting during a year of unusually low income — such as early retirement before Social Security kicks in — is ideal. A bear market also creates a smart conversion opportunity because the depressed account value means you convert more shares for less taxable income.

Qualified Charitable Distributions (QCDs)

If you’re 70½ or older, you can donate up to $105,000 per year (2024 limit) directly from your IRA to a qualified charity. The distribution satisfies your RMD but is excluded from your MAGI. This can keep you below an IRMAA threshold that your RMD alone would have triggered.

Tax-Loss Harvesting

Selling investments at a loss to offset capital gains lowers your taxable income. You can use up to $3,000 in net capital losses per year to offset ordinary income. Carrying forward unused losses to future years helps maintain a lower MAGI over time.

Income Timing and Structuring

You can accelerate or defer income into specific tax years to control your MAGI. If you’re planning a large capital gain event (like a home sale), consider spreading it across two tax years. If you have control over when you receive a bonus or pension lump sum, timing it outside the two-year look-back window can save thousands.

Health Savings Accounts (HSAs)

If you’re still working and enrolled in a high-deductible health plan before Medicare, maximize HSA contributions. HSA contributions reduce your AGI, and qualified withdrawals in retirement are tax-free and excluded from MAGI.

How to Appeal IRMAA Using Form SSA-44

You are not stuck paying IRMAA if your income has dropped because of a major life event. The SSA allows you to request a new initial determination using Form SSA-44 — officially called the “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event” form.

Step-by-Step Appeal Process

Step 1: Identify a qualifying life-changing event. The SSA only recognizes specific events. Not every income drop qualifies. A Roth conversion, for example, does not count as a life-changing event.

Step 2: Complete Form SSA-44. The form requires details about the event and your current income projections. You’re asking the SSA to use your current or recent income instead of the two-year-old tax return.

Step 3: Gather supporting documentation. Include proof that the event occurred and that it reduced your income. Examples include a termination letter, death certificate, divorce decree, or pension cancellation notice.

Step 4: Submit your appeal. You can submit Form SSA-44 by mail, fax, or in person at your local Social Security office. You can also call the SSA directly at (800) 772-1213.

Qualifying Life-Changing Events

Qualifying EventExample
Work stoppageYou retired or were laid off
Work reductionYou cut your hours significantly
Death of a spouseYour spouse passed away, reducing household income
MarriageYou married and your combined income is lower
Divorce or annulmentYou divorced, changing your filing status
Loss of income-producing propertyA rental property was destroyed or sold at a loss
Loss or reduction of pensionYour employer terminated or reduced your pension

Deadlines You Cannot Miss

You have 60 days to request an appeal after receiving your IRMAA determination letter. The SSA assumes you receive the letter five days after it’s time-stamped. That means your real deadline is roughly 65 days from the letter’s date. Missing this deadline can forfeit your right to appeal for that year.

If your initial appeal is denied, don’t panic. There are multiple levels of appeal — including reconsideration, an Administrative Law Judge hearing, and review by the Medicare Appeals Council.

Mistakes That Cost Retirees Thousands

Retirees make predictable errors with IRMAA that are entirely avoidable with proper planning. Each mistake below has a direct financial consequence.

MistakeConsequence
Ignoring municipal bond interest in MAGITax-exempt interest gets added back, pushing you over a bracket
Doing a large Roth conversion in a single yearOne-time MAGI spike triggers IRMAA for that look-back year
Not tracking income in the two-year look-back windowYou discover the surcharge after it’s too late to adjust
Missing the 60-day appeal deadlineYou lose the right to appeal for the entire year
Filing married-but-separately without understanding bracket impactYou skip directly to the 3.2x premium tier ($649.20/month)
Selling a home without planning for the capital gainGain pushes MAGI into a higher bracket two years later
Assuming a Roth conversion qualifies as a “life-changing event”The SSA will deny your appeal — Roth conversions do not qualify
Forgetting that both spouses pay IRMAAA couple’s combined surcharge is double the individual amount

The single most damaging mistake is failing to plan ahead. Because IRMAA uses a two-year look-back, you must think about your Medicare premiums before making major financial moves — not after.

Do’s and Don’ts for Managing IRMAA

Do ThisDon’t Do This
Do estimate your MAGI two years ahead every DecemberDon’t wait until you receive the SSA letter to take action
Do spread Roth conversions over multiple low-income yearsDon’t convert a large lump sum in a single year
Do use QCDs to satisfy RMDs without increasing MAGIDon’t take RMDs as cash if you don’t need the income
Do file Form SSA-44 immediately after a qualifying eventDon’t miss the 60-day appeal deadline
Do calculate the IRMAA cost before selling a propertyDon’t assume your home sale exclusion eliminates all capital gains
Do coordinate with a tax advisor who understands IRMAADon’t rely on generic tax software without checking IRMAA impact
Do check if your spouse’s death qualifies for an appealDon’t assume the “widow penalty” is unavoidable

Weighing the IRMAA Inflation Adjustment System

The fact that IRMAA brackets adjust for inflation has both benefits and drawbacks for Medicare beneficiaries.

ProsCons
Inflation indexing prevents bracket creep — you won’t get pushed into a higher tier just because of general price increasesThe 5th bracket is frozen until 2028, so the wealthiest tier does experience bracket creep
Annual adjustments reflect real economic conditions through the CPI-UCPI-U may not reflect actual medical cost inflation, which tends to run higher
Brackets are announced in advance (fall of prior year), giving some planning timeThe two-year look-back means you’re locked in before you even know the final brackets
Lower-income beneficiaries stay protected — the standard premium threshold rises each yearThe cliff effect means $1 over the line costs the full surcharge — no gradual phase-in
IRMAA revenue helps fund Medicare for all beneficiariesThe system is complex and most retirees don’t understand it until they’re already paying

Key Organizations and How They Interact

Several federal agencies play a role in how IRMAA works. Understanding who does what helps you know where to go when you need answers.

The Social Security Administration (SSA) determines your IRMAA amount, sends you the determination letter, and processes appeals filed on Form SSA-44. The Centers for Medicare & Medicaid Services (CMS) sets the standard Part B premium and announces the IRMAA brackets each fall.

The Internal Revenue Service (IRS) provides your tax return data to the SSA. Your MAGI from two years ago is what the SSA uses to place you in a bracket. The Bureau of Labor Statistics (BLS) publishes the monthly CPI-U data that CMS uses to calculate inflation adjustments for IRMAA brackets.

If there’s a discrepancy — for instance, you filed an amended tax return that the SSA hasn’t received — you need to contact both the IRS (to confirm the amended return was processed) and the SSA (to request a recalculation). The SSA won’t automatically pick up an amended return unless you notify them.

What the 2027 and 2028 IRMAA Brackets Might Look Like

The official 2027 IRMAA brackets won’t be released until fall 2026. Your 2025 MAGI determines your 2027 IRMAA. Early estimates from The Finance Buff project the first bracket for single filers at approximately $111,000 (up from $109,000) — assuming inflation between 0% and 3%.

For 2028, there are no data points yet. Preliminary estimates under a 3% inflation scenario suggest the single-filer threshold could reach $115,000 and the joint threshold could reach $230,000. A unique development for 2028 is that the frozen 5th bracket may finally be eligible for inflation indexing, which would raise the $500,000/$750,000 thresholds for the first time since 2018.

Estimated Bracket 12027 (Projected)2028 (Projected, 3% Inflation)
Single filer$111,000$115,000
Joint filer$222,000$230,000

These are estimates only. The actual numbers depend on CPI-U data through August of each respective year. Planning conservatively — keeping your MAGI $5,000 to $10,000 below the estimated threshold — is the safest approach.

How IRMAA History Reveals the Trend

From 2007 to 2025, IRMAA bracket thresholds have increased by between 4.73% and 8.02% per year. IRMAA brackets were frozen during several years of low inflation (2007 through 2019 saw very modest changes), then jumped sharply in 2020–2023 when inflation surged.

The Part B surcharge amounts have also climbed. In 2007, the highest Part B surcharge was far lower in dollar terms than today’s $487.00 per month at the top bracket. Medicare Part D surcharges didn’t even exist until 2011, when the ACA added them.

These historical trends make one thing clear: IRMAA costs are growing over time. Even with inflation indexing, the surcharge amounts reflect the rising cost of Medicare itself — which tends to increase faster than general inflation. Proactive income management is more important today than at any point since IRMAA was created.

FAQs

Are IRMAA brackets adjusted for inflation every year?

Yes. The first four IRMAA brackets are adjusted annually using the CPI-U. The fifth bracket is frozen at $500,000/$750,000 until at least 2028.

Can I appeal my IRMAA if I did a Roth conversion?

No. A Roth conversion is not a qualifying life-changing event under Form SSA-44. You can only appeal based on events like retirement, job loss, or death of a spouse.

Does selling my house affect my Medicare premiums?

Yes. Capital gains from a home sale are included in your MAGI. Even after the $250,000/$500,000 exclusion, remaining gains can push you into a higher IRMAA bracket two years later.

Is IRMAA permanent once I start paying it?

No. IRMAA is recalculated every year based on your MAGI from two years prior. If your income drops, your surcharge will be reduced or eliminated the following year.

Does IRMAA apply to Medicare Advantage plans?

Yes. IRMAA surcharges apply to both Original Medicare and Medicare Advantage plans. The surcharge is added to your Part B and Part D premiums regardless of plan type.

Can both spouses be charged IRMAA?

Yes. If both spouses are enrolled in Medicare and their joint income exceeds the threshold, each spouse pays the full IRMAA surcharge individually — effectively doubling the household cost.

Does tax-exempt interest count toward IRMAA?

Yes. Municipal bond interest and other tax-exempt income gets added back to your AGI when calculating MAGI for IRMAA purposes, even though it’s not taxed on your federal return.

Can I get reimbursed for overpaid IRMAA?

No. If your appeal is approved, your surcharges may be adjusted going forward, but there is no refund for past IRMAA payments already made.

What happens if I miss the 60-day IRMAA appeal deadline?

No, you generally cannot appeal after the deadline. The SSA gives you 60 days from receipt of the determination letter. Late filings may be considered only in rare hardship circumstances.

Will the frozen 5th bracket ever be adjusted for inflation?

Yes. Under current law, the 5th bracket ($500,000/$750,000) becomes eligible for inflation indexing starting in 2028. Whether Congress changes the law before then remains uncertain.