Income-Related Monthly Adjustment Amount (IRMAA)

Definition

Income-Related Monthly Adjustment Amount (IRMAA) is an additional amount that may be added to Medicare Part B, Medicare Part D, or both when the income information used by Social Security is above the annual level set for the premium year.

How the determination works

The Centers for Medicare & Medicaid Services establishes the annual premium and adjustment amounts. Social Security generally uses the most recent federal tax return information available from the IRS, often from two years before the premium year, together with tax filing status.

For IRMAA, modified adjusted gross income generally means adjusted gross income plus tax-exempt interest. The current SSA-44 instructions identify Form 1040 line 11 for adjusted gross income and line 2a for tax-exempt interest.

What IRMAA is not

It is not the standard Part B premium.
It is not a Part B or Part D late-enrollment penalty.
It is not the monthly premium charged by a private Medicare Advantage or drug plan.
It is not a state Medicaid or Medicare Savings Program eligibility decision.

Example

A person receives an SSA notice adding IRMAA to Part B and Part D based on an earlier tax return. The person later retires and expects substantially lower income. Retirement may fit the work-stoppage category on Form SSA-44, allowing the person to ask Social Security to use more recent income information. Social Security, not this website, decides the request.

Reduction request and appeal are different

Form SSA-44 requests a new initial determination after a listed life-changing event. If the tax information is wrong, the person filed an amended return, or the person disputes the decision for another reason, the notice may require a reconsideration or another contact route. Use the exact instructions in the notice.