Medicare IRMAA Explained

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  • High-income earners may pay a Medicare IRMAA, which are higher premiums for their Medicare Part B and Part D coverage. Learn more about the Medicare income-related monthly adjustment amount (IRMAA) and how it may affect you.

Medicare beneficiaries who earn higher incomes may have to pay an additional fee on top of their monthly Medicare Part B and Medicare Part D premiums called the Income-Related Monthly Adjustment Amount, or IRMAA.

How is IRMAA Calculated?

IRMAA is calculated using the income reported on your tax returns from two years prior. Your 2021 IRMAA amount is determined by your reported income in 2019.

The income used to calculate the Medicare IRMAA is taken from your Modified Adjusted Gross Income (MAGI) – which is your total adjusted gross income plus any tax-exempt interest – from two years prior. The MAGI limits displayed in the charts below may be adjusted for inflation every year.

What Is the Medicare IRMAA for 2021?

Most Medicare Part B beneficiaries pay the standard premium of $148.50 per month in 2021, which applies to anyone who reported an individual income at or below $88,000 in 2019, or a married couple who earn no more than $176,000 per year in 2019.

Those who earn more than that amount will be subject to Medicare IRMAA amounts according to the income thresholds displayed below.

Medicare Part B IRMAA
2019 Individual tax return 2019 Joint tax return 2019 Married and separate tax return 2021 Part B monthly premium
$88,000 or less $176,000 or less $88,000 or less $148.50
More than $88,000 and up to $111,000 More than $176,000 and up to $222,000 N/A $207.90
More than $111,000 up to $138,000 More than $222,000 up to $276,000 N/A $297.00
More than $138,000 up to $165,000 More than $276,000 up to $330,000 N/A $386.10
More than $165,000 up to $500,000 More than $330,000 up to $750,000 More than $88,000 up to $412,000 $475.20
More than or equal to $500,000 More than or equal to $750,000 More than or equal to $412,000 $504.90


Beneficiaries of Medicare Part D prescription drug plans may also pay a monthly premium for their drug coverage. Unlike Medicare Part B, which is standardized by the federal government, Part D plans are sold by private insurance companies, so monthly premiums can vary between plans and providers.

But while Medicare Part D plans are sold by private insurers, an IRMAA fee still applies to higher income earners according to the chart below.

Medicare Part D IRMAA
2019 Individual tax return 2019 Joint tax return 2019 Married and separate tax return 2021 Part D monthly premium

$88,000 or less

$176,000 or less

$88,000 or less

Your plan premium

More than $88,000 and up to $111,000

More than $176,000 and up to $222,000

N/A

$12.30 + your plan premium

More than $111,000 up to $138,000

More than $222,000 up to $276,000

N/A

$31.80 + your plan premium

More than $138,000 up to $165,000

More than $276,000 up to $330,000

N/A

$51.20 + your plan premium

More than $165,000 up to $500,000

More than $330,000 up to $750,000

More than $88,000 up to $412,000

$70.70 + your plan premium

More than or equal to $500,000

More than or equal to $750,000

More than or equal to $412,000

$77.10 + your plan premium


It’s worth pointing out that high-income beneficiaries with both Medicare Part B and Part D must pay the IRMAA amounts for both parts. The Part D IRMAA may also apply to you if you have a Medicare Advantage (Medicare Part C) plans that include prescription drug benefits.

Can You Appeal the Medicare IRMAA?

If the Social Security Administration determines that you are subject to the Medicare IRMAA, you will receive a notice in the mail called an “initial determination.” The notice will include instructions for how to file for a revised determination, which will initiate a review of your income to verify your IRMAA requirement.

You may file for a revised determination if you have experienced a life-changing event that may have triggered incorrect income information. Qualifying life-changing evens include:

  • Death of a spouse
  • Marriage, divorce or annulment
  • Stoppage or reduction of work
  • Involuntary loss of income-producing property due to a natural disaster, disease, fraud or other circumstances
  • Loss of pension
  • Receipt of settlement payment from a current or former employer due to the employer’s closure or bankruptcy
  • Filing an amended tax return or having a more recent tax return than the one used by the Social Security Administration

You will need to provide documentation of your life-changing event to file for a revised determination of your IRMAA status.

If you did not experience a life-changing event, you may still appeal your IRMAA status. Contact the Social Administration at 800-772-1213 or by visiting your local Social Security office and request an appeal or “reconsideration.”

If this appeal is denied, you may then appeal to the Office of Medicare Hearings and Appeals (OMHA) within 60 days. Instructions for filing this appeal can be found on the notice informing you of the initial appeal denial. 

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