What Is IRMAA, and What Are IRMAA Brackets for 2024?

What is IRMAA?

The Medicare income-related monthly adjustment amount (IRMAA) is a surcharge on Medicare Part B (medical insurance) and Part D prescription drug plan premiums. It applies only to Medicare beneficiaries with a modified adjusted gross income above $103,000 (individual return) or $206,000 (joint return).

How is IRMAA calculated?

The Medicare IRMAA for Part B and Part D is based on your income and is calculated on a sliding scale. When determining whether IRMAA applies to you, Medicare uses the adjusted gross income amount reported on your tax return from two years prior.

Is IRMAA based on gross income or taxable income?

Your IRMAA amount is determined based on the modified adjusted gross income (MAGI) from your tax return two years ago.

Do capital gains count toward IRMAA?

Yes, since capital gains are included in MAGI, they can affect your IRMAA.

Do Social Security benefits count toward IRMAA?

Yes, the taxable portion of your Social Security benefits is used to calculate your MAGI, and MAGI determines your IRMAA.

» MORE: Turning 65? When to sign up for Medicare and Social Security

What are the 2024 IRMAA brackets?

IRMAA is based on your income and your tax filing status. Brackets for Part B and Part D are the same, but the additional amount you pay varies. Both the brackets and the additional amount you pay change each year.

Medicare Part B IRMAA brackets

If the Part B IRMAA applies to you, the amount you owe will be added to your Part B premium, which is $174.70 per month in 2024 for most people.

For 2024, beneficiaries whose 2022 income exceeded $103,000 (individual return) or $206,000 (joint return) will pay a premium amount ranging from $244.60 to $594, depending on income.

2024 Medicare Part B IRMAA brackets

Source: Medicare.gov

2024 Medicare Part B IRMAA for immunosuppressive drug coverage only

Starting in 2023, certain Medicare beneficiaries who aren't eligible for Medicare because they're 36 months post-kidney transplant can continue to receive Part B coverage of immunosuppressive drugs if they pay a premium. The Part B premium for immunosuppressive drugs only is $103 per month in 2024. A Medicare Part B IRMAA applies to these enrollees as well.

Source: Medicare.gov

Medicare Part D IRMAA brackets

2024 Medicare Part D IRMAA brackets

Source: Medicare.gov

» MORE: How much does Medicare Part D cost?

Does IRMAA apply to Medicare Advantage plans?

IRMAA applies to all Medicare beneficiaries whose earnings are high enough to make them eligible, even those on Medicare Advantage. That’s because everyone on Medicare Advantage still owes the Part B premium of $174.70 per month in 2024, along with any applicable IRMAA charges.

Additionally, if you have a Medicare Advantage plan that includes prescription drug coverage, the Part D IRMAA also applies.

How do I know if I have to pay the Medicare IRMAA?

When you enroll in Medicare, you'll initially pay the standard Part B premium and your Part D premium until Social Security receives your income data from the IRS. If your income is high enough for IRMAA to apply, Social Security will mail a predetermination notice.

This notice will explain that IRMAA will apply, how this determination was made and how to proceed if any of this information is in error or your situation has changed.

After sending out the predetermination notice, Social Security will mail you an initial determination notice informing you that you owe IRMAA on your Part B and Part D (if applicable) premiums. This notice also includes how the determination was made and instructions on what to do if you think it isn't correct. If you receive an initial determination notice, hang onto it and keep it in a safe place.

How do I pay the Medicare IRMAA surcharge?

If you're receiving retirement benefits from Social Security and already have your Medicare Part B and Part D (if applicable) premiums deducted from your Social Security payment, your IRMAA will automatically be deducted from your Social Security benefit.

The same applies if you receive Railroad Retirement Board benefits — your Part B IRMAA and Part D IRMAA are typically deducted from your payment.

If you don't have any Medicare premiums deducted from your Social Security payment or Railroad Retirement Board benefits, you'll receive a bill for your Part B and Part D IRMAAs.

» MORE: Are Medicare premiums tax-deductible?

Can I get my IRMAA reduced?

If you believe your IRMAA determination isn't correct, you've got the right to appeal. To do so, contact the Social Security Administration to request that your IRMAA determination be reconsidered. You can call 800-772-1213 to request an appeal form or fill out a Request for Reconsideration.

You don’t necessarily have to file an appeal. You can contact the SSA at 800-772-1213 and request a new look if your income has declined or if your tax return was amended. You’ll need to provide copies of documents that support your claim.

If you experienced a life event that affected your income, such as retirement or divorce, fill out the Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event form (SSA-44). You can fax or mail the form to your local Social Security office.

To qualify for a change in IRMAA determination, you'll have to show that your tax return was out of date or inaccurate for one of these reasons, according to HHS.gov:

• The IRS data contained an error.

• The IRS sent old data and you'd like them to use newer information.

• A beneficiary filed an amended tax return for the year the Social Security Administration used to make the IRMAA decision.

• Your income has recently decreased significantly due to one of these life-changing events: death of a spouse, marriage, annulment or divorce, reduction or loss of work, loss of income from income-generating property, and reduction or loss of certain types of pension income.

Does Social Security automatically adjust IRMAA?

The Social Security Administration updates your IRMAA determination each year based on your federal tax return, which is provided by the IRS. If you filed an amended tax return that would affect your IRMAA amount, contact the SSA so they can update their records.