The Part D IRMAA Surcharge: Income-Based Premium Add-Ons
Higher incomes pay an income-related monthly adjustment amount (IRMAA) stacked on top of any Part D premium — a surcharge set by CMS from your tax return from two years prior, tiered in five bands. It is easy to confuse with the Part B IRMAA, which arrives on the same tax data.
| Filing status (single) | 2025 MAGI window | 2025 Part D IRMAA |
|---|---|---|
| ≤ $106,000 | Standard premium only | $0 |
| $106,000–133,000 | Band 1 | ≈ $13.70/month |
| $133,000–167,000 | Band 2 | ≈ $35.30/month |
| $167,000–200,000 | Band 3 | ≈ $57.00/month |
| $200,000–500,000 / $750k joint | Band 4 | ≈ $78.60/month |
| $500,000+ / $750,000+ joint | Band 5 | ≈ $85.80/month |
The two-year lookback and life-change appeals
IRMAA uses your adjusted gross income from two years back — 2026 surcharges key off 2024 returns. That punishes retirees whose income spikes in the year before Medicare: a large capital gain or Roth conversion at 63 raises premiums at 65. SSA’s life-changing event appeal (form SSA-44) can re-tier if income has since dropped due to retirement, marriage, divorce or work stoppage — one of the most under-used fixes in Medicare planning.
Planning around IRMAA
Pre-65 retirees should sequence retirement account withdrawals and Roth conversions with the IRMAA bands in mind — a $5,000 mis-step across a band boundary costs roughly $165/year in Part D surcharges plus up to $1,600 in Part B IRMAA. After 65, qualified charitable distributions from IRAs and careful capital-gain timing keep MAGI under thresholds. The surcharge is per-person, so joint filers each carry their own tier.
FAQ
Is Part D IRMAA separate from Part B IRMAA?
Yes — both key off the same income bands but are separate surcharges; high earners pay both simultaneously.
What if my income drops after I retire at 64?
File SSA-44 with proof of the work stoppage; SSA re-tiers prospectively rather than waiting out the two-year lookback.
Do Roth withdrawals raise IRMAA?
No — qualified Roth distributions are tax-free and do not count toward MAGI, which is why Roth conversions before 65 are a classic IRMAA hedge.
Related reading: Part D 2026 overview · Late penalty · Medigap vs drugs · Medicare FAQs