IRMAA after retirement can be frustrating because your Medicare premiums may be based on income you earned before you retired.
Medicare generally uses tax-return information from two years earlier to determine whether you pay an Income-Related Monthly Adjustment Amount, commonly called IRMAA.
If your income has dropped because you retired or stopped working, you may be able to ask Social Security to use more recent income information instead.
If your Medicare Part B or Part D premium increased because of IRMAA, the amount may be based on income reported on a tax return from two years earlier.
If you have since retired, stopped working, or experienced another qualifying life-changing event that reduced your income, you may be able to ask Social Security to reconsider your IRMAA.
This is generally done using Form SSA-44 and documentation showing both the life-changing event and your expected lower income.
IRMAA stands for Income-Related Monthly Adjustment Amount.
It is an additional amount some higher-income Medicare beneficiaries pay on top of their standard Medicare Part B premium and their Part D prescription drug coverage.
IRMAA is not a separate insurance plan or permanent penalty. It is an income-based adjustment that can change from year to year as your income changes.
Social Security determines whether IRMAA applies using income information provided by the IRS.
Medicare generally bases IRMAA on your modified adjusted gross income from two years earlier because that is usually the most recent federal tax-return information available when premiums are determined.
For example, your 2026 Medicare premiums generally use income reported on your 2024 federal tax return.
That can create a problem after retirement. Your income two years ago may have included wages, bonuses, or other income that you no longer receive.
This is why someone can retire with substantially lower income and still initially receive an IRMAA notice based on their higher pre-retirement earnings.
IRMAA uses your modified adjusted gross income (MAGI).
For IRMAA purposes, this generally means your adjusted gross income plus tax-exempt interest.
Income that can affect your IRMAA calculation may include wages, pensions, IRA or 401(k) withdrawals, taxable Social Security benefits, investment income, capital gains, and other taxable income.
This is why a large one-time income event can sometimes affect your Medicare premiums two years later.
Social Security recognizes certain life-changing events that can justify using a more recent estimate of your income when determining IRMAA.
Work stoppage, including retirement, is one of those qualifying events.
If you retire and your income decreases, you may be able to ask Social Security to reconsider your IRMAA based on your expected lower income rather than the older tax return.
You generally need to provide evidence of the work stoppage and an estimate of your reduced modified adjusted gross income.
Form SSA-44 is the Social Security form used to request a reduction in IRMAA after certain life-changing events.
The form lets you report the qualifying event, such as retirement or another work stoppage, and provide an estimate of your lower modified adjusted gross income.
You may also need documentation supporting the life-changing event and your income estimate.
Submitting SSA-44 does not automatically guarantee a reduction. Social Security reviews the information and determines whether your IRMAA should be changed.
Retirement is not the only event Social Security recognizes for an IRMAA reconsideration.
Other qualifying life-changing events can include marriage, divorce or annulment, death of a spouse, work reduction, loss of income-producing property, loss of certain pension income, and an employer settlement payment.
Not every drop in income qualifies.
For example, ordinary investment losses or voluntarily selling investments generally are not treated the same as one of Social Security’s specified life-changing events.
Yes. IRMAA is recalculated each year using updated income information.
You might pay IRMAA one year and not the next, or move into a different IRMAA bracket as your income changes.
That makes retirement-income planning important because events such as large IRA withdrawals, Roth conversions, capital gains, or other taxable income can potentially affect future Medicare premiums.
IRMAA should be viewed as an annual income-based adjustment, not necessarily a permanent increase in your Medicare costs.
Don’t assume the amount on your initial IRMAA notice is necessarily what you must pay for the entire year.
If your income has decreased because of a qualifying life-changing event, you can ask Social Security to reconsider the determination.
The important question is why your income decreased and whether that reason qualifies under Social Security’s IRMAA reconsideration rules.
If retirement or another qualifying event applies, gather the documentation and updated income estimate before requesting the reconsideration.
IRMAA is another reason Medicare and retirement-income decisions should be considered together.
Before retirement, look at how your wages, retirement-account withdrawals, Roth conversions, investment gains, pensions, and Social Security income may affect your future taxable income.
You may not be able to avoid IRMAA every year, and avoiding IRMAA should not automatically override a better financial decision.
The goal is to understand the potential Medicare impact before making major income decisions rather than discovering it two years later.
IRMAA is the Income-Related Monthly Adjustment Amount. It is an additional amount some higher-income Medicare beneficiaries pay for Part B and Part D based on their income.
Social Security generally uses tax-return information from two years earlier because it is usually the most recent federal tax information available when Medicare premiums are determined.
Possibly. Retirement or another work stoppage is a qualifying life-changing event. If it causes your income to decrease, you may be able to ask Social Security to reconsider your IRMAA using more recent income information.
Form SSA-44 is used to request an IRMAA reduction following certain qualifying life-changing events. You report the event and provide information about your reduced or expected income.
The taxable portion of your Social Security benefits can be included in adjusted gross income and therefore can affect the income used to determine IRMAA.
Yes. Taxable IRA withdrawals and taxable income created by Roth conversions can increase modified adjusted gross income and potentially affect IRMAA two years later.
No. IRMAA is recalculated annually. Your adjustment can increase, decrease, or disappear as the income information used by Social Security changes.
Yes. You can request a new determination following a qualifying life-changing event, and there are also appeal rights if you disagree with Social Security’s IRMAA determination.
I’m David Lowe, RSSA® — Registered Social Security Analyst® and a licensed Medicare agent.
I help people approaching retirement understand how Medicare and Social Security planning can overlap with IRMAA and retirement-income decisions.
You work directly with me. No call center. No rotating team of agents.
My goal is to help you understand IRMAA and Medicare timing before an income or retirement decision creates an unexpected Medicare cost.
I am not employed by Medicare, the Social Security Administration, or the IRS.
IRMAA determinations depend on your individual tax information, income, and circumstances.
Medicare guidance can help explain how IRMAA affects your premiums, but tax planning decisions should be reviewed with a qualified tax professional when appropriate.
For official information about IRMAA and reconsiderations, you can also review SSA.gov and Medicare.gov.
I provide Medicare guidance in the states where I am licensed:
If you’re approaching retirement or dealing with an IRMAA adjustment, I can help you understand how Medicare premiums fit with your Social Security and retirement decisions.
If you’ve retired, reduced your work, or received an unexpected IRMAA notice, it may be worth reviewing why the adjustment was applied.
We can look at your Medicare premiums, retirement timing, Social Security, and whether a qualifying life-changing event may allow you to request a new IRMAA determination.
David Lowe, RSSA®
Registered Social Security Analyst®
Licensed Medicare Agent
Mirkwood55