Surprised by Higher Medicare Premiums? Understanding IRMAA and Your Options
Many retirees are surprised when their Medicare premiums are higher than expected. You planned for your Medicare Part B premium ($185/month in 2025, projected $206.50/month in 2026), but then an extra charge shows up on your bill. That extra cost is called IRMAA, and it can feel like a nasty surprise.
The good news? Once you understand IRMAA, you’ll know why it happens, how it affects Tricare for Life (TFL), and what you can do about it.
What is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an additional charge added to your Medicare Part B (and sometimes Part D) premiums if your income is above a certain level.
Instead of everyone paying the same “standard” Part B premium, higher-income beneficiaries pay more. These surcharges go directly to Medicare, not Tricare, and TFL does not cover them.
How is IRMAA Calculated?
The Social Security Administration (SSA) determines whether you owe IRMAA based on your Modified Adjusted Gross Income (MAGI) from your IRS tax return two years ago.
Your 2023 income determines your 2025 IRMAA.
Your 2024 income will determine your 2026 IRMAA.
If your MAGI is above certain thresholds, IRMAA applies. The higher your income bracket, the higher your premium.
Why Does IRMAA Exist?
Medicare is heavily subsidized by federal tax dollars. On average, most beneficiaries only pay about 25% of the actual cost of their Part B coverage, while the government covers the rest.
In 2003, Congress decided that higher-income beneficiaries should pay a larger share to help sustain Medicare’s funding. That’s why IRMAA was created.
If your income is above certain thresholds, you pay more than the standard premium. The higher your income, the larger your share of the program’s cost.
IRMAA Brackets for 2025
Individuals: IRMAA begins if your MAGI is above $103,000.
Married couples filing jointly: IRMAA begins if your MAGI is above $206,000.
The surcharge increases in steps as your income rises, sometimes more than doubling your monthly premium.
For the most up-to-date thresholds, see Social Security’s official IRMAA brackets.
(We’ll update these numbers as CMS finalizes 2026 premiums in October.)
How Does IRMAA Affect Tricare for Life?
TFL is designed to wrap around Medicare’s deductibles, coinsurance, and copays. It does not pay for premiums, including IRMAA.
This means:
You pay your Medicare Part B premium.
If IRMAA applies, you pay that surcharge directly to Medicare.
Once those are paid, TFL works as your secondary payer, picking up your Medicare cost-shares for covered services.
Can You Appeal IRMAA? (Yes—and here’s how)
If you’ve experienced a qualified life-changing event that reduced your income—like retirement, work reduction, loss of spouse, divorce, or loss of pension—you can request a reduction or waiver of IRMAA by submitting Form SSA-44 to the Social Security Administration. This form allows SSA to reconsider your Medicare surcharges using more recent income data.
You’ll need to:
Download the form from SSA: SSA-44: Request for Life-Changing Event IRMAA review
Check off the qualifying event and include the event date (month/year).
Provide income info: For the affected year, include your AGI (from IRS Form 1040 Line 11) and tax-exempt interest (Line 2a).
Attach documentation supporting both the life event (e.g., retirement letter, divorce filing, death certificate) and your income (signed tax return or IRS transcript).
Submit the form by mailing or dropping it off at your local SSA office — or upload it online via SSA's portal.
Wait for SSA’s decision, and continue paying IRMAA until you hear back to avoid coverage gaps or penalties.
Important note: SSA only considers the specific events listed on the form. If your income change doesn’t match one, appeals are less likely to be approved.
Appealing a Decision Online
If you disagree with SSA’s decision about your IRMAA, you can file an appeal online through Social Security’s secure portal: File an IRMAA appeal online.
You may also:
File a written Request for Reconsideration (Form SSA-561-U2)
Or contact your local Social Security office for assistance.
📞 Social Security: 1-800-772-1213 (TTY 1-800-325-0778)
Note: If your income went down due to a life-changing event (like retirement or loss of pension), use Form SSA-44 instead of filing an appeal.
Tips for Managing IRMAA
Plan ahead for taxes: Withdrawals from IRAs or large capital gains can raise your income and trigger IRMAA. Work with a financial advisor to time withdrawals strategically.
Watch for one-time income events: Selling property, cashing in investments, or large distributions can push you into IRMAA brackets for two years. Consider the timing.
Appeal if your income drops: If you retire, lose a pension, or experience another qualifying event, file Form SSA-44 to request a reduction.
Closing Thoughts
IRMAA can be frustrating, especially when it catches you off guard. But knowing how it works can help you plan ahead, and in many cases, you can reduce or avoid it with smart financial decisions.
Want to better understand how IRMAA, Medicare, and Tricare for Life fit together? TFLCI is here to help you navigate the process and prepare for what’s ahead.