What is IRMAA for Medicare recipients?

William Lewkowski • May 29, 2025

What Is IRMAA and How Does It Affect Your Medicare Costs?

If you're enrolled in Medicare—or planning to be—you may have heard of something called IRMAA. No, it's not a new type of Medicare plan. It stands for Income-Related Monthly Adjustment Amount, and it can significantly impact what you pay each month for your Medicare Part B and Part D coverage.

Let’s break down what IRMAA is, who it affects, and how to plan for it.


What Is IRMAA?

IRMAA is an additional monthly premium charged to higher-income Medicare beneficiaries. It applies to both:

  • Part B (Medical Insurance) — which covers things like doctor visits and outpatient care.
  • Part D (Prescription Drug Coverage) — which helps pay for medications.

While most Medicare enrollees pay a standard monthly premium, those with higher incomes pay an extra amount on top of that. This extra cost is what’s referred to as IRMAA.


Who Has to Pay IRMAA?

IRMAA applies if your Modified Adjusted Gross Income (MAGI) from two years ago exceeds certain thresholds. That means your 2023 tax return is used to determine your 2025 premiums.

For 2025, IRMAA kicks in if your MAGI is:

  • Over $106,000 (single filers)
  • Over $212,000 (married couples filing jointly)

If your income falls below those thresholds, you’ll only pay the standard premiums.



How Much More Could You Pay?

The amount of IRMAA you pay depends on your income tier. The higher your income, the higher your IRMAA surcharge. These amounts are set annually by the Social Security Administration and apply in addition to your regular Part B and Part D premiums. The 2025 IRMAA premiums can be found at Medicare.gov.

It’s important to note that Part D IRMAA is paid separately—not to your plan provider, but directly to Medicare.



Can You Appeal IRMAA?

Yes, you can. If your income has dropped due to a life-changing event, such as:

  • Retirement
  • Loss of income-producing property
  • Divorce
  • Death of a spouse

…you may be able to request a reduction or removal of your IRMAA. You’ll need to file Form SSA-44 with documentation that supports your case. If approved, your IRMAA amount will be adjusted accordingly.



How Is IRMAA Paid?

If you receive Social Security or Railroad Retirement benefits, IRMAA is automatically deducted from your benefit check.

  • If you don't receive those benefits, you’ll get a bill from Medicare that can be paid online, via online banking, or by check through the mail.



Why It Matters for Your Planning

If you’re approaching Medicare eligibility and have higher income, IRMAA should be part of your financial planning. Your current income may qualify you for IRMAA, but if you're retiring soon, your income may drop, and you could avoid or reduce these extra costs using the appeals process. Knowing that helps you avoid surprises—and gives you time to file an appeal if needed.



The Bottom Line

IRMAA can come as a surprise if you’re not expecting it, but it’s manageable with a little preparation. Understanding how your income affects your Medicare premiums can help you make smarter decisions about retirement timing, tax strategies, and health plan choices.



Need help?

Do you have questions about how IRMAA might impact you—or need help navigating your Medicare options? We’re here to help. Contact our office for personalized guidance tailored to your income and healthcare needs.


An elderly woman is getting her eyes examined by an ophthalmologist
By William Lewkowski July 15, 2025
When you enroll in Medicare, you get access to hospital and medical insurance through Parts A and B—but many people are surprised to learn that it doesn’t cover everything. In fact, some of the most commonly needed services—like routine dental, vision, and hearing care—are not included in Original Medicare . The good news? You do have options . Whether through Medicare Advantage plans or standalone coverage, there are several ways to make sure these essential health needs don’t fall through the cracks. The Limitations of Original Medicare Original Medicare (Parts A and B) does a great job of covering hospital stays, doctor visits, and medically necessary procedures. But it does not cover most routine care for your eyes, ears, or teeth. That means these important services are entirely out-of-pocket expenses on Original Medicare: Dental cleanings, fillings, dentures, and extractions Eye exams for glasses or contacts\ Hearing tests and hearing aids There are a few exceptions to this. For example, Medicare may cover an eye exam if you have diabetes, or it might pay for eyeglasses after cataract surgery. Similarly, it could cover a dental procedure if it's necessary before a major surgery like a heart valve replacement. But as a general rule of thumb, routine care in these areas isn't covered. Medicare Advantage: An All-in-One Option If you’re looking for more complete coverage, a Medicare Advantage Plan (also known as Part C) might be a good fit. These plans are offered by private insurance companies and provide the same coverage as Original Medicare—and beyond. Most Medicare Advantage plans include benefits for: Dental care : Routine exams, x-rays, cleanings, and sometimes more complex services like crowns or dentures. Vision care : Annual eye exams, and allowances for glasses or contact lenses. Hearing care : Screenings and sometimes partial or full coverage for hearing aids. These plans often require you to use a network provider, so it's important to check which dentists, eye doctors, or audiologists are included. Costs can vary—some benefits may be included at no extra charge, while others might involve copays or set annual limits. To enroll in a Medicare Advantage plan, you must already be enrolled in both Parts A and B, and live in the plan’s service area. You can compare plans during the Annual Enrollment Period (Oct. 15–Dec. 7) or if you qualify for a Special Enrollment Period. Learn more about Medicare Advantage with this handy booklet from Medicare.gov. Standalone Coverage and Other Resources If you prefer to stick with Original Medicare or your current Medicare Advantage plan doesn’t include the coverage you want, you can fill in the gaps with other options instead: 1. Standalone Dental, Vision, and Hearing Insurance Many private insurers offer separate policies specifically for dental, vision, or hearing coverage. These plans vary in price and coverage, but typically include preventive care and a network of providers. 2. Discount Plans Discount plans are not insurance plans, but rather offer reduced rates on services for a monthly or annual fee. This might be a good fit if you just need occasional care and want to lower the out-of-pocket cost. 3. Community and Federally Funded Clinics Some Federally Qualified Health Centers (FQHCs) and local health departments offer dental and vision services at a reduced cost or on a sliding fee scale. These can be especially helpful for people on a fixed income. 4. Veterans Benefits If you’re a veteran, you may have access to dental, vision, or hearing benefits through your local VA, depending on your eligibility. Don’t Skip Out on These Services It might be tempting to put off a dental cleaning or skip an eye exam, especially if it’s not covered—but these services are vital to your overall health. Gum disease has been linked to heart disease, untreated vision problems can increase fall risk, and hearing loss has been associated with cognitive decline. Preventive care matters, and making sure you have the right coverage in place can help you stay healthier—and save money—in the long run. Final Thoughts If you’re on Medicare, dental, vision, and hearing benefits aren’t automatic—but they are available. Whether through a Medicare Advantage plan or other coverage, you can build a plan that supports your total health. Need help comparing options or understanding what’s available in your area? We’re here to help you make sense of it all.
By William Lewkowski April 30, 2025
5 Medicare Mistakes to Avoid This Spring