Most people on Medicare pay the standard Part B and Part D premiums. However, some pay more due to an Income Related Monthly Adjusted Amount, or IRMAA. An income-based sliding scale determines your Medicare Part B and Part D adjustments.

What is Income Related Monthly Adjusted Amount

IRMAA stands for Income Related Monthly Adjustment amount. This IRMAA is a surcharge added to your Medicare Part B and Part D monthly premiums. Part B IRMAA took effect in 2007, and Part D IRMAA took effect in 2011.

The amount you pay for the Medicare program depends on how much you make annually. Beneficiaries that make more than $97,000 a year could be affected by IRMAA.

IRMAA Determinations

Your IRMAA adjustment gets determined by the modified adjusted gross income shown on tax returns from two years ago. The income levels that determine the adjustment 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 it’s 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 defined by the Centers for Medicare & Medicaid Services.

Part B IRMAA Adjustments For 2023

You can expect the increases in the chart below for beneficiaries making more than $97,000 or $194,000 in household income. Suppose you’re required to pay an IRMAA due to higher income. In that case, you can expect the increase to be added to your Medicare Part B monthly premium.

The determination depends on how you’re filing the income tax return, either married, filing a joint tax return, or filing an individual return for the tax year.

The Income Related Monthly Adjustment Amount is based on your income from two years prior.
Beneficiaries who file individual tax returns with modified adjusted gross income:Beneficiaries who file joint tax returns with modified adjusted gross income:Income-Related Monthly Adjustment AmountTotal Monthly Premium Amount in 2023
$97,000 or less$194,000 or less$0.00$164.90
$97,000 to $123,000$194,000 to $246,000$65.90$230.80
$123,000 to $153,000$246,000 to $306,000 $164.80$329.70
$153,000 to $183,000$306,000 to $366,000$263.70$428.60
$183,000 to $500,000$366,000 to $750,000 $362.60$527.50
$500,000 or above $750,000 or above $395.60$560.50

Part D IRMAA Adjustments For 2023

The Medicare Part D IRMAA works a little differently than Part B IRMAA. Part D drug plans have different premiums. Because of this, the additional surcharge gets tacked onto the Medicare beneficiary’s plan premium amount.

The Income Related Monthly Adjustment Amount is based on your income from two years prior.
Beneficiaries who file individual tax returns with modified adjusted gross income:Beneficiaries who file joint tax returns with modified adjusted gross income:Income-related monthly adjustment amount for 2023
Less than or equal to $97,000Less than or equal to $194,000$0.00
Greater than $97,000 and less than or equal to $123,000Greater than $194,000 and less than or equal to $246,000$12.20 + Plan Premium
Greater than $123,000 and less than or equal to $153,000Greater than $246,000 and less than or equal to $306,000$31.50 + Plan Premium
Greater than $183,000 and less than $500,000Greater than $366,000 and less than $750,000$70 + Plan Premium
$114,000 to $1Greater than or equal to $500,000Greater than or equal to $750,000$76.40 + Plan Premium

Premiums for high-income bracket beneficiaries whose filing status is married. And they lived with their spouse at any time during the taxable year, but filed a separate return, are as follows:

Beneficiaries who are married and lived with their spouses at any time during the year, but file separate tax returns from their spouses, with modified adjusted gross income:
Income-related monthly adjustment amount
Less than or equal to $97,000$0.00
Greater than $97,000 and less than $403,000$70.00
Greater than or equal to $403,000$76.40


How do I know if I have an IRMAA?

Suppose Social Security determines that you’re subject to an IRMAA surcharge. In that case, the Social Security Administration(SSA) will notify you by letter 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 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 qualifying life-changing event, loss of income, 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 reduces 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 one than the one used for Initial Determination. You’ll use the Medicare IMRAA Life-Changing event form to apply for redetermination.

How do I 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 determination?

Yes! Some areas have Medicare Advantage plans that reduce the amount you pay for your Part B premium.

How to Get Help with My IRMAA

Fill out our online request form, or give us a call. We can look at your area and help determine if you have access to a plan to help lower your costs. Some programs can reduce items such as your Medicare Part B premium or monthly premium for your prescription drug coverage.

Our licensed insurance agents can also look at your Medicare costs and see if additional medical insurance or Medicare coverage is available.

Written By:
Picture of the author
Lindsay Malzone, Lindsay Malzone is the Medicare editor for She's been contributing to many well-known publications 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.
Reviewed By:
Picture of the expert
Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.