Key Takeaways
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The 2025 IRMAA income brackets have shifted upward due to inflation adjustments, potentially affecting your Medicare Part B and Part D premiums.
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Your 2023 tax return is being used to determine your 2025 IRMAA level, so your income from two years ago could increase what you pay now.
What Is IRMAA and Why It Matters in 2025
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B and Part D premiums if your income is above a certain threshold. In 2025, these brackets have been adjusted again for inflation, which means more people could cross into higher payment tiers—even if their income hasn’t substantially changed.
You don’t enroll in IRMAA—it’s applied automatically by the Social Security Administration (SSA) based on the modified adjusted gross income (MAGI) reported on your IRS tax return from two years ago. For 2025, that means your 2023 tax return determines whether you’ll pay IRMAA.
2025 IRMAA Income Thresholds
The base Medicare Part B premium in 2025 is $185 per month. If your income is below the IRMAA threshold, this is all you pay. However, once your income exceeds the threshold, you’ll face additional monthly charges.
Here are the 2025 IRMAA brackets:
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Individual MAGI under $106,000 / Married Filing Jointly under $212,000: No IRMAA. You pay the standard premium.
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$106,000 – $133,500 / $212,000 – $267,000: Higher premium tier.
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$133,501 – $166,000 / $267,001 – $332,000: Second IRMAA tier.
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$166,001 – $199,000 / $332,001 – $398,000: Third IRMAA tier.
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$199,001 – $249,750 / $398,001 – $499,500: Fourth IRMAA tier.
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Above $249,750 / Above $499,500: Highest IRMAA tier.
Each tier increases your monthly Part B premium and adds a surcharge to your Medicare Part D drug plan.
Part D Surcharges in 2025
In 2025, Medicare Part D also carries IRMAA charges for those in higher income brackets. These surcharges are added on top of your plan’s premium—not included in it—and are paid directly to Medicare, not your insurance provider.
Like with Part B, these are tied to the same 2025 IRMAA income brackets. The surcharges range from around $13 to over $80 per month per person.
How the SSA Notifies You
If you’re subject to IRMAA, the SSA will send you a determination letter called an “Initial IRMAA Determination.” This notice outlines how your premium was calculated and what tier you fall into.
These letters are typically mailed in November or December of the year before the premium changes take effect—in this case, late 2024 for your 2025 premiums.
What Counts as Income?
For IRMAA, Medicare uses your Modified Adjusted Gross Income (MAGI), which includes:
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Adjusted Gross Income (AGI) from your tax return
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Tax-exempt interest income (like municipal bond interest)
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Foreign income, if applicable
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Certain deductions that are added back, such as student loan interest and IRA contributions
Because of this broad definition, even seemingly non-taxable income sources can bump you into a higher IRMAA bracket.
Common Triggers That Increase IRMAA
Many retirees are surprised when they first receive an IRMAA notice. Common reasons include:
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Selling a home or investment property in 2023
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Taking large distributions from retirement accounts (e.g., traditional IRAs)
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Receiving bonuses or stock option payouts before retiring
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Filing jointly and having a spouse with continued high income
These one-time income spikes can affect your premiums for an entire year unless you appeal.
Appealing Your IRMAA Charges
If your circumstances have changed since 2023, you can file an appeal using Form SSA-44. This is especially relevant if you’ve experienced a life-changing event, such as:
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Retirement
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Death of a spouse
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Divorce or annulment
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Loss of pension income
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Reduced work hours or work stoppage
You’ll need to provide supporting documentation—such as a retirement letter or final pay stub—to support your claim. If approved, your IRMAA charge may be reduced or waived entirely for the current year.
Strategic Planning to Reduce Future IRMAA
You can’t change your 2023 income now, but you can take steps today to manage your future exposure to IRMAA. Consider the following planning strategies:
1. Roth Conversions Early in Retirement
Before you hit age 65, consider converting portions of your traditional IRA or 401(k) into a Roth account. Although this creates taxable income in the short term, it reduces future required minimum distributions (RMDs) that could bump your MAGI above the IRMAA thresholds later.
2. Withdraw Strategically
After 65, try to control your taxable income by:
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Taking only what you need from tax-deferred accounts
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Drawing from Roth IRAs or cash reserves instead of taxable investments
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Delaying Social Security if it helps keep your income under the threshold
3. Time Capital Gains Carefully
If you’re planning to sell appreciated assets, be mindful of when the gain is recognized. A large capital gain in one year can increase your IRMAA two years later.
4. Coordinate with a Tax Advisor
Work closely with a financial advisor or tax professional who understands Medicare’s impact on retirement income. They can help you forecast your MAGI and make adjustments to stay within lower brackets.
IRMAA and Married Couples: Joint Planning Is Essential
For married couples filing jointly, both individuals will be subject to the same IRMAA surcharge, even if only one person is on Medicare. This makes joint tax planning essential.
Consider whether it makes sense to:
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File separately in certain years (though this usually increases IRMAA risk)
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Balance income sources between spouses
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Adjust investment withdrawals to keep household MAGI under a key threshold
Your 2023 Tax Return Still Matters in 2025
It’s easy to forget what happened two years ago, but for Medicare, your 2023 tax return is what matters in 2025. Any income events—planned or unplanned—from two years back could be impacting your premium today.
This time gap makes proactive planning even more important. You’re not just planning for this year’s income—you’re managing your future IRMAA exposure two years ahead.
Where to Go From Here
Understanding IRMAA can help you avoid sticker shock and stay in control of your Medicare costs. If you think you’re at risk for higher premiums—or have already received a determination letter—it’s important to act.
A licensed agent listed on this website can help you:
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Review your current Medicare costs
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Understand how IRMAA affects your total out-of-pocket expenses
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Explore strategies to manage your income and coverage together
