Medicare Premium Adjustments (IRMAA)
How income and life-changing events can affect Medicare Part B and Part D premiums
How income affects Medicare premiums
Most people pay the standard Medicare Part B premium and the premium charged by their Medicare Part D plan.
If your income is above certain limits, you may also pay an additional amount called the Income-Related Monthly Adjustment Amount, or IRMAA.
IRMAA applies to:
- Medicare Part B medical coverage
- Medicare Part D prescription drug coverage
Social Security determines whether IRMAA applies based on:
- Your income
- Your federal tax-filing status
- Income reported on your federal tax return from two years earlier
Social Security reviews updated income information each year and automatically adjusts your IRMAA when appropriate.
Watch: Understanding IRMAA
Download: 2026 IRMAA Amounts
The Two-Year Look-Back Rule
The Social Security Administration determines IRMAA using your Modified Adjusted Gross Income (MAGI) reported on your federal tax return from two years earlier.
2024 income → 2026 Medicare premiums
The problem is that income from two years ago may not reflect your current income after retirement or major change.
Retired in 2025? Your 2026 Medicare premium may still be based on the income you earned in 2024.
If your income remains above the applicable limits, IRMAA may continue to apply. If your income decreased because of a qualifying life-changing event, you may be able to request an earlier review.
Life-Changing Events
Sometimes income decreases significantly after a major life event, but Medicare premiums may still reflect higher income from two years earlier.
Social Security recognizes the following qualifying life-changing events:
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- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage
- Work reduction
- Loss of income-producing property
- Loss of pension income
- Employer settlement payment
Retirement generally falls under work stoppage, while moving to part-time work or reducing your hours may fall under work reduction.
An income decrease alone does not always qualify. The decrease generally must be connected to one of Social Security’s recognized life-changing events.
When to Submit a Request
You may be ready to submit a request when:
- You are enrolled in Medicare Part B
- You received an IRMAA notice from Social Security
- You experienced a qualifying life-changing event
- Your income decreased or is expected to decrease
- You have documentation supporting the event and income change
Watch: How to Complete the Life Event Form
How to Request a Review
Use Form SSA-44: Medicare IRMAA – Life-Changing Event to request a review
The form allows you to:
- Report your qualifying life-changing event
- Provide updated or estimated income information
- Submit documentation supporting the change
Before completing the form, gather documentation showing:
- The qualifying life-changing event
- Your updated or estimated income
Ways to Submit
You can submit your completed form and supporting documentation:
- Online through your Social Security account
- By fax or mail to your local Social Security office
- By calling Social Security 1-800-772-1213
Complete or Upload Your Request Online
Find Your Local Social Security Office
Keep a copy of your completed form, supporting documents and submission confirmation.
What Happens After You Submit?
Social Security will review your life-changing event, updated income and supporting documentation.
If your request is approved:
- Social Security will recalculate your IRMAA
- Your Part B and, when applicable, Part D adjustment may be reduced or removed
- The change may be applied retroactively to the applicable premium period
- Excess premiums already paid may be refunded or applied as a credit
Social Security will send you a new determination notice explaining its decision. Processing times vary.
Need More Help?
For questions about IRMAA, Form SSA-44, or a submitted request, contact Social Security at 800-772-1213 or your local Social Security office.