Medicare’s Income-Related Monthly Adjustment Amount (IRMAA) is an additional charge that may be added to your monthly Part B and Part D premiums if your annual income exceeds a certain threshold.
Each year, the Social Security Administration sets IRMAA income brackets to determine whether you’ll need to pay extra fees on top of your standard Medicare Part B and Part D premiums.
If you’re enrolled in Medicare Part B (medical insurance) and/or Part D (prescription drug coverage) and your income is above the established threshold, you may have to pay an additional surcharge.
IRMAA is calculated using a sliding scale based on income brackets, which are adjusted annually for inflation. The income assessment has a two-year lag, meaning your 2024 IRMAA is based on your 2022 tax return.
This article covers 2025 IRMAA income brackets, how IRMAA is calculated, and how the surcharge is applied to your Medicare premiums.
Income brackets and surcharge amounts for Part B and Part D IRMAA
Types of Income That May Trigger IRMAA
The Medicare surcharge is based on your modified adjusted gross income (MAGI) from two years prior. To determine if you’ll owe IRMAA in 2025, check your 2023 tax return.
For IRMAA purposes, MAGI includes your adjusted gross income (AGI) plus:
- Tax-exempt interest, such as income from municipal bonds, which can be significant for many retirees.
- Interest from U.S. savings bonds used for qualified education expenses.
- Foreign income that was excluded from gross income.
- Nontaxable income from U.S. territories, including Puerto Rico, Guam, American Samoa, and the Northern Mariana Islands.
A well-planned Roth IRA conversion may help you avoid IRMAA since withdrawals from Roth accounts do not count toward MAGI.
The good news is that if your financial situation changes due to a life-changing event—such as the death of a spouse or loss of pension income—you can appeal and request a redetermination of your IRMAA assessment.
How to Pay Your Part B and Part D IRMAA
The IRMAA surcharges for Part B and Part D are paid separately. Part B IRMAA is automatically added to your monthly premium bill, while Part D IRMAA must be paid directly to Medicare, not to your plan or employer. Even if your employer or another party (like a retirement system) covers your Part D plan premiums, you’re still responsible for paying the Part D IRMAA. Medicare will send you a bill each month for the Part D IRMAA, and you can pay it in the same way as your Part B premiums.
All Medicare bills are due on the 25th of the month, and in most cases, your premium is due the same month you receive the bill. If you miss a payment or if Medicare receives your payment late, your next bill will include any past-due amounts.
Four Ways to Pay Your Part B Premium
- Online through your secure Medicare account: This is the fastest option. You can pay using a credit card, debit card, or from your checking or savings account. Do not create or use a Pay.gov account for Medicare payments—use your Medicare account instead.
- Sign up for Medicare Easy Pay: This free service automatically deducts your premium payments from your checking or savings account each month. It can take 6-8 weeks to start, so you’ll need to pay your premiums by another method until the automatic deductions begin.
- Mail your payment: You can pay by check, money order, credit card, or debit card. Complete the payment coupon at the bottom of your bill and include it with your payment. If paying by credit or debit card, ensure you sign the coupon. If you don’t have the coupon, write your Medicare Number on the check or money order. Use the return envelope provided to mail your payment.
- Use your bank’s online bill payment service: Set up payments through your bank’s online bill payment feature.
IRMAA Notification and How to Address It
If Social Security determines that you need to pay an IRMAA, you will receive an initial determination notice. This notice will explain how to request a new initial determination if you believe it is incorrect.
If a “life-changing event” has affected your income, such as the death of a spouse or loss of income, you can request a reduction or waiver of your premiums. If your redetermination request is denied, you can appeal the decision. There are three levels of appeals:
- Office of Medicare Hearings and Appeals
- Medicare Appeals Council
- Federal district court in your area
You may need to hire an attorney for higher-level appeals, especially if they involve coverage decisions.
Bottom Line
IRMAA is a “cliff” surcharge, meaning that if your modified adjusted gross income exceeds the threshold by even a small amount, you’ll face higher premiums. Your eligibility is based on income from two years prior. In 2025, the IRMAA will be based on your 2023 income.
To reduce the risk of paying IRMAA, avoid one-time income spikes that could trigger the surcharge. Timing a Roth IRA conversion properly can help you avoid IRMAA by reducing taxable income in the year you convert.
Need help? Call Health Plans in Oregon: 503-928-6918. Our assistance is at no cost to you.
