For those who receive Social Security, seeing a high increase in the amount withdrawn for the Medicare Income Related Monthly Adjustment Amount (IRMAA) can be a shock.

While most Medicare Part A and Part B premiums are fixed amounts for most beneficiaries, IRMAA, which is a tiered system that adds an additional monthly premium if your Modified Adjusted Gross Income (MAGI) exceeds a set threshold, can add hundreds of dollars to monthly costs. This can also influence Part D premiums.

The official Medicare Premium changes and IRMAA brackets have not been released for 2026, but financial sites, such as Kiplinger and AARP are projecting increases close to 9% for Standard Part B and for IRMAA surcharges. The charges are based on a two-year look-back rule, which means your 2026 premiums are based on your 2024 MAGI.

Even people who do not normally have a high income can exceed the threshold at which IRMAA kicks in, as even an amount as small as $1 over a tier will push the beneficiary into the next highest tier and can mean a difference of hundreds of dollars to monthly costs. Some ways that can happen include:

• Selling investments from a taxable account
• The sale of property, including rental, where capital gains are generated
• Taking a large distribution from a pre-tax retirement account
• Excess gambling winnings

Since 2025’s MAGI will be used to calculate IRMAA for 2027, if your MAGI will be greater than $212,000 for a married couple ($106,000 for a single taxpayer), there are ways you can manage your income to help avoid a hefty increase, or 

avoid the IRMAA surcharge altogether. Some of the ways you can manage your income include contributing to a retirement plan, making Qualified Charitable Distributions (QCDs), where money is transferred from your traditional IRA directly to a charity, taking advantage of tax credits and deductions.

Of course, if your financial circumstances in 2024 mean IRMAA will start or increase in 2026, it is too late to adjust your income. Once you receive your determination letter, though, there are certain life events that may impact your IRMAA and can be used to appeal your determination:

• Marriage, Divorce or Annulment
• Loss of a Spouse
• Retirement or Reduced Work Hours
• Loss of Income-Producing Property
• Pension Plan Termination or Reorganization
• Settlement from Employer

This appeal should be filed within 60 days of receiving your determination letter. During the appeal process, you must submit an SSA-44 form to the Social Security Administration. With the form, you will need to include proof of the life-changing event and an estimate of your reduced income, such as tax returns, pay stubs, or any documentation that shows your current income. The SSA reviews appeals on a case-by-case basis with no guarantee of a successful outcome, however if the appeal is not upheld, you can then file a formal appeal with the Medicare Appeals Council.

Considerations during the appeals process include the accuracy of your MAGI, whether there were errors in the calculation of your IRMAA, and if the circumstances and change in your income warrant a reduction in your IRMAA.

If your appeal succeeds, you will receive a new determination letter from the SSA with a recalculated IRMAA.

Year-end is an important time to consider what actions you can take to offset a potential IRMAA increase. Our office can help with your tax planning needs! Give us a call to schedule – 425-258-3432.