Many new retirees get an unwelcome surprise in their first year on Medicare: a letter from Social Security saying their Part B and Part D premiums will be higher than standard. That extra charge is the income-related monthly adjustment amount (IRMAA). It is based on your income from two years earlier, when you may still have been working full time.
The good news: if your income has dropped because of a qualifying life event, you can ask Social Security to use a more recent year. This guide explains how.
Why the lookback catches retirees
For 2026 premiums, Social Security uses the modified adjusted gross income (MAGI) on your 2024 tax return. MAGI for IRMAA is your adjusted gross income plus tax-exempt interest.
Someone who retired in 2025 had 2024 income that included a full salary, perhaps a bonus or a final payout. So they can be placed in a high IRMAA bracket for 2026, even though their current income is much lower.
In 2026 the standard Part B premium is $202.90 a month. Individuals with 2024 MAGI above $109,000, or couples above $218,000, pay more, from $284.10 to $689.90 a month per person, plus a Part D surcharge of $14.50 to $91.00. Check your bracket with the IRMAA calculator.
Two ways to challenge IRMAA
- A life-changing event (Form SSA-44). Your income has gone down, or will go down, because of a qualifying event. You ask Social Security to use a more recent year’s income, or an estimate for the current year.
- A request for reconsideration (Form SSA-561). Use this if the income figure Social Security used is wrong: the IRS data is incorrect, you filed an amended return, or your filing status was recorded incorrectly.
Most retirees use the first route.
Which events qualify
Social Security recognizes these life-changing events:
- Work stoppage: you retired or stopped working.
- Work reduction: you cut your hours or took lower-paying work.
- Marriage.
- Divorce or annulment.
- Death of your spouse.
- Loss of income-producing property, due to a disaster or other event beyond your control (not an ordinary sale).
- Loss or reduction of certain kinds of pension income, for example if a pension plan ends or reduces benefits.
- An employer settlement payment, such as a payment because an employer closed or went bankrupt.
What doesn’t qualify: income that was high only because of a one-time choice, such as a large capital gain, a Roth conversion or an IRA withdrawal. Planning around those is covered below.
Step by step: filing Form SSA-44
- Confirm your bracket. Read your IRMAA determination letter, or use the calculator to see the bracket your lookback-year MAGI falls into.
- Pick the year to use. Usually that’s the current year, if your income has already dropped, or the year after the lookback year. You’ll report your actual or estimated MAGI for that year.
- Gather evidence of the event. For example:
- a letter from your employer confirming your retirement date or reduced hours;
- a marriage certificate, divorce decree or death certificate;
- pension-plan letters.
- Gather evidence of the lower income. A signed tax return for the newer year, if you’ve filed it. Otherwise, your estimate plus supporting documents such as pay records or benefit statements.
- Complete Form SSA-44. It asks for the event, its date, your MAGI for the year you want used, and your filing status.
- Submit it to Social Security. You can mail or deliver it to your local office, or call Social Security to complete it by phone or in person. Keep copies of everything.
- Watch for the decision. If Social Security approves, your premium is recalculated, and any overpayment is refunded or credited. If it’s denied, you can request reconsideration.
Tip: If you’re using an estimate, Social Security will later compare it with your filed tax return. Estimate honestly and carefully. If your actual income turns out higher, your IRMAA can be adjusted again.
Planning to avoid IRMAA spikes
Because of the two-year lookback, income decisions you make now affect your Medicare premiums two years later. A few strategies help:
- Watch the thresholds. Brackets are cliffs, so $1 over a threshold means paying the full surcharge for the year. Before a Roth conversion or a big asset sale, check how much room you have.
- Spread Roth conversions across several years to stay within a bracket. Or do larger conversions before Medicare begins, while remembering the ACA subsidy cliff if you buy Marketplace coverage (see our ACA subsidy cliff guide).
- Use qualified charitable distributions (QCDs) from IRAs once you’re 70½. They count toward required minimum distributions but are excluded from AGI.
- Plan home sales. Gains above the home-sale exclusion ($250,000 single, $500,000 joint, if you qualify) add to MAGI.
- Remember what doesn’t help. Deductions taken after AGI don’t reduce IRMAA MAGI. That includes the standard deduction, itemized deductions and the new senior deduction (see the senior deduction calculator).
Frequently asked questions
Does IRMAA last forever? No. It’s redetermined every year from your latest available tax return, so if your income falls, IRMAA drops away automatically two years later. The SSA-44 appeal just gets you there sooner.
Do both spouses pay IRMAA? Each person on Medicare pays their own premium. For joint filers, both spouses’ premiums are based on the couple’s joint MAGI.
Does Medicare Advantage avoid IRMAA? No. Part B IRMAA applies however you get your coverage, and Part D IRMAA applies if your plan includes drug coverage.
Sources:
- Social Security: Medicare premiums, rules for higher-income beneficiaries
- Form SSA-44
- CMS: 2026 Medicare Parts A & B premiums and deductibles
- IRS Publication 590-B (qualified charitable distributions)