The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your Part B or Part D premium if your income is above a certain level. The Social Security Administration (SSA) sets four income brackets that determine your (or you and your spouse’s) IRMAA. SSA determines if you owe an IRMAA based on the income you reported on your IRS tax return two years prior, meaning two years before the year that you start paying IRMAA. The income that counts is the adjusted gross income you reported plus other forms of tax-exempt income.

If you are expected to pay IRMAA, SSA will notify you that you have a higher Part B premium.

Your premium will change based on income as follows:
Your annual income Your monthly premium in 2024
Individuals Couples
Equal to or below $103,000 Equal to or below $206,000 $174.70
$103,001 -$129,000 $206,001 – $258,000 $244.60
$129,001 – $161,000 $258,001 – $322,000 $349.40
$161,001 – $193,000 $322,001 – $386,000 $454.20
$193,001 – $499,999 $386,001 – $749,999 $559
$500,000 and above $750,000 and above $594

If you believe you should not pay IRMAA, your circumstances have changed, or your IRMAA was miscalculated, you have the right to request that SSA lower or eliminate your premium increase. You will have to submit evidence whether you are appealing SSA’s original determination or requesting a new determination.