Most people on Medicare pay the standard Part B and Part D premiums. However, some pay more. An income-based sliding scale is used to determine your Medicare Part B and Part D adjustments.

What is Income Related Monthly Adjusted Amount?

IRMAA stands for Income Related Monthly Adjusted amount. A surcharge is added to your Medicare Part B and Part D premiums. The Part B IRMAA took effect in 2007, and the Part D IRMAA took effect in 2011.

The amount you pay for Medicare depends on the amount of money you make annually. Beneficiaries that make more than $91,000 a year could be affected by IRMAA.

IRMAA Determinations

Your IRMAA adjustment is based on your tax returns from two years ago. The income levels that determine the IRMAA are reviewed annually and subject to change.

The good news is that the IRMAA isn’t permanent in most cases. As your income gets lower due to retirement, your IRMAA will lower and ultimately disappear. If you feel like the IRMAA should not apply or is an incorrect assessment, there is a process to appeal the surcharge.

Income counted towards the IRMAA includes wages, capital gains, dividends, social security income, rental income, pensions, interest, and any distributions from tax-deferred investments like a 401k.

All these sources of income are considered adjusted gross income, plus any tax interest as defined by CMS.

How much are the Part B IRMAA adjustments in 2022?

For beneficiaries making more than $91,000 or $182,000 for household income, you can expect to see the increases depicted in the chart below.

The Income Related Monthly Adjustment Amount is based on your income from two years prior.
File individual tax returnFile joint tax returnFile married & separate tax returnYou pay each month in 2022
$91,000 or less$182,000 or less$91,000 or less$170.10
$91,000 to $114,000$182,000 to $228,000Not applicable$238.10
$114,000 to $142,000$228,000 to $284,000 Not applicable$340.20
$114,000 to $142,000$228,000 to $284,000Not applicable$442.30
$170,000 to $500,000$340,000 to $750,000 $91,000 to $409,000$544.30
$500,000 or above $750,000 or above $409,000 or above $578.30

Part D IRMAA works a little differently than Part B IRMAA. Part D plans have different premiums. Because of this, the surcharge is added to the premium of the plan you are enrolled into.

The Income Related Monthly Adjustment Amount is based on your income from two years prior.
File individual tax returnFile joint tax returnFile married & separate tax returnYou pay each month in 2022
$91,000 or less$182,000 or less$91,000 or lessPlan Premium
$91,000 to $114,000$182,000 to $228,000Not applicable$12.40 + Plan Premium
$114,000 to $142,000$228,000 to $284,000 Not applicable$32.10 + Plan Premium
$114,000 to $142,000$228,000 to $284,000Not applicable$51.70 + Plan Premium
$170,000 to $500,000$340,000 to $750,000 $91,000 to $409,000$71.30 + Plan Premium
$500,000 or above $750,000 or above $409,000 or above $77.90 + Plan Premium

How Do I Know if I Have an IRMAA?

Suppose Social Security determines that you’re subject to an IRMAA surcharge. In that case, you’ll be notified in a letter from Social Security in any given year that it applies. The notification provides information about your income, how much you will pay due to IRMAA, and how those surcharges affect your social security benefits. The notification is called Initial Determination.

Can I Challenge the IRMAA determination?

If you feel the determination is incorrect or have a life-changing event, you can appeal the IRMAA determination. When you receive your Initial Determination notice, it should include the process of requesting a new Initial Determination.

How to Request a New Initial Determination?

Requesting a new Initial Determination is possible if you meet specific criteria. If you have a life-changing event or believe Social Security has used incorrect or outdated information.

Examples of life-changing events include the following:

  • Divorce
  • Marriage
  • Death of a spouse
  • You or your spouse stops working or reducing the number of hours
  • Loss of pension
  • Receipt of a settlement payment from a former or current employer due to the employer’s bankruptcy or closing

To request a new Initial Determination due to incorrect or outdated income information. You must provide an amended tax return to the IRS or a more recent tax return than the one used for Initial Determination. You’ll use the Medicare IMRAA Life-Changing event form to apply for redetermination.

How to Appeal the IRMAA determination?

Suppose you disagree with the IRMAA determination and don’t qualify for a new Initial Determination. In that case, you have the right to appeal. The formal name of the appeal is requesting a reconsideration. There are strict timelines that Social Security must abide by to appeal. Contact Social Security for more information on the appeal process.

I don’t qualify for reconsideration. Is there anything I can do to offset the IRMAA?

Yes! Some areas have Medicare Advantage plans that reduce the amount you pay for your Part B premium. Fill out our online request form, or give us a call. We can look at your area and help you find out if you have access to a plan that will help lower your Part B premium.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.