Medicare IRMAA Surcharge Notice — What It Means & What to Do

Dr. Ed's Insider Info Verified Resource

What This Letter Means:

This letter means SSA looked at your tax return from two years ago and decided your income was high enough to charge you a higher Medicare Part B (and sometimes Part D) premium. This is called IRMAA — Income-Related Monthly Adjustment Amount. The standard Part B premium in 2026 is $202.90/month. If your income was above $106,000 (single) or $212,000 (married filing jointly), you pay more.

But here's what most people miss: if your income has DROPPED since that tax year — because you retired, lost a job, got divorced, or your spouse died — you can appeal and get the surcharge removed.

Why You Got This Letter

Your Modified Adjusted Gross Income (MAGI) from 2 years ago exceeded IRMAA thresholds
SSA uses your tax return from 2 years prior — 2024 return for 2026 premiums
Common scenario: You were still working full-time in 2024 but retired in 2025 — your 2024 income was high, but your current income is much lower
IRS reported your income to SSA automatically

2026 IRMAA Income Brackets

Single Filer	Married Filing Jointly	Part B Monthly Premium	Surcharge
≤$106,000	≤$212,000	$202.90	$0
$106,001–$133,000	$212,001–$266,000	$285.90	$83.00
$133,001–$167,000	$266,001–$334,000	$408.20	$205.30
$167,001–$200,000	$334,001–$400,000	$530.50	$327.60
$200,001–$500,000	$400,001–$750,000	$652.80	$449.90
>$500,000	>$750,000	$694.90	$492.00

What to Do Now — 6-Step Action Plan

Check which income year SSA used: It's 2 years ago — for 2026 premiums, they used your 2024 tax return.
Ask yourself: Has my income DROPPED significantly since that tax year? (Retirement, job loss, divorce, spouse died, lost pension/annuity, work reduction)
If YES → File Form SSA-44 (Request for Reconsideration) with proof of your life-changing event and estimated current income.
If NO → Your IRMAA is correct. Consider strategies to reduce future IRMAA: Roth conversions, QCDs, managing capital gains.
Gather proof: Letter from former employer showing retirement date, divorce decree, death certificate, most recent tax return showing lower income.
File SSA-44 at your local SSA office, by mail, or by calling 1-800-772-1213.

Important: No hard deadline for IRMAA appeal, but file ASAP — you keep paying the higher premium until the appeal is processed.

Understanding Your Appeal Options

Life-Changing Events That Qualify for Appeal ▼

You can appeal your IRMAA if you've experienced any of the following life-changing events. You only need ONE of these to qualify:

Marriage — Your marital status changed since the income year used
Divorce or Annulment — Your income is now separate from your former spouse
Death of Spouse — You're no longer filing jointly or supporting two incomes
Work Stoppage (Retirement) — You stopped working and no longer earn employment income
Work Reduction — You transitioned to part-time work and earned significantly less
Loss of Income-Producing Property — You sold or lost rental property, business, or investment income
Loss of Pension — Your pension was reduced or eliminated
Employer Settlement Payment — You received a settlement that was counted as income in the old tax year

Filing Tip: SSA will recalculate your IRMAA based on your ESTIMATED current income, not the old tax return. This is your chance to show your actual current situation.

How to Fill Out Form SSA-44 ▼

Step-by-Step Form Instructions

Section 1: Your Information

Fill in your name, Social Security number, date of birth, and contact phone number
This is straightforward — match what's on your IRMAA letter

Section 2: Which Life-Changing Event Applies to You?

Check the box that matches your situation (retirement, job loss, divorce, etc.)
Be specific about the date it happened (month/year)
If multiple events occurred, explain all of them — more detail helps your case

Section 3: Your Estimated Current Year Income

This is the key section. Don't leave it blank.
Estimate what you expect to earn in the current year based on your current situation
Include: W-2 wages (if still working), Social Security benefits, pensions, investment income, rental income
Example: If you retired, estimate just your Social Security and pension — not the $180,000 salary you made before
SSA will use THIS estimate instead of your 2-year-old tax return

Attach Proof of Your Life-Changing Event:

Retirement: Letter from employer confirming retirement date, or recent pay stub showing $0 earned
Job Loss: Termination letter or unemployment benefits award letter
Divorce: Divorce decree (certified copy)
Spouse's Death: Death certificate (certified copy)
Income Drop: Most recent tax return showing lower income, pay stubs, pension statements

Where to Send It:

Your local Social Security office (in person or by mail)
By phone: Call 1-800-772-1213 and they'll mail you the form
Processing time: Usually 30–60 days

IRMAA and Part D (Prescription Drug Coverage) ▼

Important: IRMAA doesn't just affect Part B (medical insurance) — it also affects Part D (prescription drug coverage).

Part D premium surcharges use the same income brackets as Part B
If your Part B IRMAA surcharge is $200, your Part D surcharge might be additional
The combined surcharge (Part B + Part D) can add $300–$600+ per month

When You Appeal:

If you file Form SSA-44 for Part B IRMAA, your Part D IRMAA is also automatically reviewed
You don't need to file separate forms — one SSA-44 covers both
Once SSA recalculates your income, both premiums adjust accordingly

Example:

You have a Part B surcharge of $205.30 and a Part D surcharge of $78.50. You file SSA-44 showing you retired. SSA recalculates and removes both surcharges. Your total monthly savings: $283.80.

📞 What to Say When You Call SSA

"I received an IRMAA determination letter. I've had a life-changing event — I [retired/lost my job/got divorced/my spouse passed away] in [year]. My income is now significantly lower than my [year] tax return shows. I'd like to file Form SSA-44 to request a reconsideration of my Medicare premium. Can you help me start that process?"

💡 Dr. Ed's Insider Tip

IRMAA catches people off guard every year because SSA uses income from TWO years ago. The most common situation I saw: someone retires in 2025 after earning $180,000. In 2026, they're living on $40,000 in Social Security. But SSA is still charging them based on the $180,000. The fix is simple — file SSA-44, show you retired, estimate your current income. SSA processes these quickly, usually 30–60 days.

And here's a tip most people miss: you can file SSA-44 BEFORE you get the IRMAA letter if you know your income dropped. Don't wait for the surcharge to hit — be proactive.

Also: if you're doing Roth conversions in retirement, be aware that conversion income counts as MAGI and can trigger IRMAA two years later. Plan your conversions carefully.