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What is IRMAA?: 5 Ways to Reduce Monthly IRMAA Payments

Written by 
Angela Myers

Article at a glance

  • IRMAA stands for income-related monthly adjustment amount. If a Medicare recipient makes over a certain amount annually, they have to pay this monthly adjustment for Medicare Part B and D. 
  • For 2024, those who make over $103,000 and file individually or joint filers with over $206,000 in income must pay IRMAA. 
  • There are ways to reduce IRMAA, such as reducing taxable income or appealing when a major life event occurs. 

Income-related monthly adjust amount, or IRMAA, is an extra amount on top of a monthly premium that applies to some Medicare recipients. It applies to Medicare Part B and Part D for those who cross a certain income threshold. Usually, this amount is deducted from someone’s Social Security or Railroad Retirement Board benefits. 

There are some ways to reduce IRMAA, such as appealing due to a major life event, receiving an amended income tax return, or reducing taxable income. Each one has a different impact on IRMAA and different regulations. 

What Is IRMAA?

Medicare is an insurance program subsidized by the federal government. Americans over the age of 65 and younger Americans with certain disabilities are eligible to enroll in Medicare

When enrolling, it’s important to remember there are different parts:

  • Part A: insurance for hospital visits and certain expenses associated with hospice, nursing care in assisted living facilities, or home health services.
  • Part B: insurance for outpatient care, doctor’s appointments, preventative services, and medical supplies.
  • Part C: a plan that covers parts A and B, but is offered by an approved private company instead of the federal government. This is also called a Medicare Advantage plan.
  • Part D: insurance plan for prescription drug coverage.

IRMAA relates to parts B and D. Most Medicare recipients pay three premiums for parts A, B, and D respectively. However, if you make over a certain amount annually, you may be responsible for an additional amount referred to as the income-related monthly adjustment amount, or IRMAA for short on parts B and D. IRMAA is on top of the monthly premiums, not in place of them. 

If someone meets the income threshold for IRMAA, Social Security sends a notice with the specific amount owed. Usually, that amount is taken out of someone’s Railroad Retirement Board or Social Security check each month. If it isn’t taken out automatically, the Railroad Retirement Board or Medicare will send a bill and the amount must be paid to keep Medicare Part B and D coverage. 

IRMAA and medicare premiums are calculated based on income. For those who make under $103,000 a year as an individual or $206,000 if married and filing jointly, IRMAA doesn’t apply. Beneficiaries who make under these amounts only have to pay their premiums. 

IRMAA calculations and income data are based on the beneficiary’s IRS tax return. Even retired beneficiaries may have higher incomes due to sources outside a traditional job.

These include:

  • Money pulled from taxable retirement accounts
  • Certain types of tax-exempt interest, such as income from bonds
  • Income-producing property
  • Capital gains on investments

If a Medicare beneficiary makes over the income threshold for their tax filing status, they have to pay an amount ranging from $69.90 to $419.30 for Part B coverage. For Part D coverage, the amount ranges from $12.90 to $81 monthly. Again, this is on top of plan premiums. 

These ranges are for 2024. Each year, Social Security calculates adjusted income thresholds and IRMAA monthly payments. Medicare recipients don’t have to calculate these amounts themselves, and Social Security is responsible for notifying anyone who owes IRMAA.

2024 IRMAA Income Brackets

As mentioned, the income brackets for IRMAA are adjusted each year. For 2024, the income brackets and IRMAA amounts are:

Individual Tax Return Filed

  • $103,000 or Less: standard premium payment
  • $103,000 up to $129,000: Part B Premium + $69.90; Part D Premium + $12.90
  • $129,000 up to $161,000: Part B Premium + $174.70; Part D Premium + $33.30
  • $161,001 up to $193,000: Part B Premium + $279.50; Part D Premium + $53.80
  • $193,001 up to $500,000: Part B Premium + $384.30; Part D Premium + $74.20
  • $500,000 and above: Part B Premium + $419.30; Part D Premium + $81.00

Married & Filing Separately

  • $103,000 or less: standard premium payment
  • $103,001-$397,000: Part B Premium + $384.30; Part D Premium + $74.20
  • $397,000 and above: Part B Premium + $419.30; Part D Premium + $81.00

Joint Tax Return Filed

  • $206,000 or less: standard premium payment
  • $206,001-$258,000: Part B Premium + $69.90; Part D Premium + $12.90
  • $258,001-$322,000: Part B Premium + $174.70; Part D Premium + $33.30
  • $322,001-$386,000: Part B Premium + $279.50; Part D Premium + $53.80
  • $386,001 up to $750,000: Part B Premium + $384.30; Part D Premium + $74.20
  • $750,000 and above: Part B Premium + $419.30; Part D Premium + $81.00

The plan premium is also adjusted based on income level. For more information on Plan D premiums and the Medicare IRMAA by income threshold, visit this resource

For Plan B premiums and IRMAA amounts, this resource may help. 

Medicare Premiums and Income

For most Medicare beneficiaries, the federal government pays 75% of all Medicare premiums and the beneficiary pays 25%. However, those with higher incomes are expected to pay a larger chunk of the parts B and D premiums.

Premiums are determined based on the same tax returns utilized for initial IRMAA determination. IRMAA premium amounts and income thresholds are redefined each year by the federal government. 

Note: To learn more about how much a monthly premium may cost, visit this resource.

IRMAA and Medicare Advantage Plans

Let’s say someone is about to retire. They prefer the health insurance from their current provider and don’t want to switch. As long as that provider is Medicare-approved, they can stick with that insurance company or choose another Medicare-approved private company, thanks to Medicare Advantage plans (MA plan). 

Medicare Advantage, also called Part C, is an optional Medicare plan where someone receives coverage through a private company. MA plans bundle more coverage than Original Medicare plans because they likely include Part A, B, and D along with other benefits such as vision, hearing, and dental insurance. Medicare will pay for a plan through these private insurers, so long as they provide Plan A and B services and the insured lives in a geographic area they cover. 

Most of these plans also include Part D coverage. Because Medicare Advantage is offered by private companies, some people believe that they don’t have to pay the IRMAA, only the plan premium, when they choose this option. This is a misconception and the same income thresholds and IRMAA amounts apply whether you have a Medicare Advantage plan or not. 

IRMAA and Medigap

Medigap is a supplemental insurance plan offered by private companies. It’s intended for those who already have Plan A and Plan B coverage and it helps pay for costs associated with original Medicare. Similar to Medicare Advantage plans, the same IRMAA income thresholds and amounts apply to those with Medigap. 

5 Ways to Reduce IRMAA

IRMAA is based on your taxable income, and there are ways to reduce the amount owed. Two of the most common include reducing your modified adjusted gross income or appealing current monthly fees. Reducing modified adjusted gross income impacts future IRMAA determination while appealing current monthly fees can modify IRMAA, Medicare Part B premiums, and Medicare Part D premiums for the current year.

Note: IRMAA is determined based on adjusted gross income pulled from tax returns two years prior, meaning any methods to reduce this year’s income will save money in the future, but not this year.

With these guidelines in mind, here are five tangible ways to reduce your IRMAA payments:

1 — Retirement Contributions

For those who are still working, tax-deductible contributions can lower their adjusted gross income. Retirement accounts that qualify for this include:

  • Traditional or solo 401K
  • Simple IRA
  • Traditional IRA

Contributions to post-tax retirement accounts, like a Roth IRA, do not impact IRMAA determination.

2 — Charitable Gifts

Eligible IRA owners can give up to $100,000 a year tax-free to charities. To ensure charitable deductions fall under acceptable income reductions, someone must donate the required minimum distributions and follow these guidelines.

3 — Tax-free Income

When beneficiaries withdraw money from a Roth IRA, a Medicare Savings account, or another tax-free income source, this money doesn’t count as earned income that impacts IRMAA determination.

4 — Receive an Amended Tax Return

If someone received an amended tax return from the IRS, their IRMAA may be adjusted. When this is the case, call +1 800–772-1213 and speak to a representative about lowering their IRMAA due to the updated return. 

5 — Major Life Events

After a major life event, a Medicare beneficiary can appeal their IRMAA. For life-changing events to impact someone’s income-related monthly adjusted amount, they must meet the Social Security’s definition of life-changing’ and medicare beneficiaries must file a formal appeal.

Social Security defines the following events as life-changing:

  • Loss of Income: this includes the loss of a pension, a property that produces revenue, or a job.
  • Work Reduction: this includes a reduce of work experienced by a beneficiary or their spouse.
  • Marriage: an official marriage certificate is needed to validate.
  • Divorce or Annulment: meaning two spouses won’t file taxes together for the upcoming year and therefore, their income is affected.
  • Loss of a Spouse: if a spouse is lost within the past year, this is deemed as life-changing’.

When one of these occurs, someone must fill out the Medicare Income-Related Monthly Adjustment Life-changing Event form. This form must be mailed or faxed to a local Social Security office. To locate the closest office, utilize this search engine.

When someone fills out this form, it’s possible for adjustments to be made to Part B and Part D premiums, along with IRMAA adjustments. 

Paying IRMAA

Most beneficiaries never receive a Medicare bill. That’s because any premiums or IRMAA owed are directly withdrawn from a Social Security or Railroad Retirement Board benefit payment. 

If someone doesn’t have benefits from either organization, they’ll get the following bills:

  • Part A every month
  • Part B every three months
  • Part D IRMAA every month

Payments are due on the 25th of each month and Medicare recommends submitting them at least five days before to ensure payment is processed on time. 

To pay a Medicare bill, there are four options:

  • Bank Account Online: Utilize a bank’s online system to pay directly from a checking or savings account.
  • Mail: Mail payment to a local Medicare office.
  • Bank Account Deduction: Enroll in Medicare Easy Pay, where Medicare will automatically deduct the amount from a bank account each month.
  • Medicare Account Online: Pay online through a secure medicare account, which Medicare claims is the fastest way to pay.


How do I reduce IRMAA?

There are a few ways to adjust IRMAA. Since it’s calculated based on income from two years ago, reducing annual adjusted gross income can lower the IRMAA in the future. To lower the IRMAA this year, someone must appeal on the basis of a life-changing event or because they received an amended income tax return.

Is IRMAA automatically adjusted each year?

IRMAA is automatically adjusted each year by Social Security. This federal office is responsible for sending notifications to anyone who owes IRMAA with the monthly amount due.

Do I have to pay IRMAA if I have a Medicare Advantage plan?

Anyone who makes over the IRMAA income threshold ($103,000 for individuals and $206,000 for couples filing jointly in 2024) must pay the appropriate IRMAA amount, regardless of whether they have a Medicare Advantage plan or not. The exact amount due each month is determined based on adjusted gross income from tax returns.

Is IRMAA deducted from social security?

Usually, IRMAA is deducted from Social Security or Railroad Retirement Board benefits. Those with these benefits don’t pay directly; instead, this amount will come out of their monthly benefits check. If someone doesn’t receive these benefits, they are responsible for making monthly IRMAA payments, due on the 25th of each month.

Do IRA contributions reduce IRMAA?

Contributions to traditional IRAs reduce the IRMAA amount due in the future, though they don’t impact how much someone is paying now. Since a Roth IRA is a retirement account populated by post-tax income, these do not impact someone’s IRMAA.

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