How to Appeal a Medicare IRMAA Surcharge

Do you know who Aunt IRMAA is? IRMAA stands for Income-Related Monthly Adjustment Amount, and it can make your Medicare Part B premium much more expensive than expected.

The good news is that if your income has gone down, you may have the right to appeal it. The appeal is no cost to you, and for many people who recently retired or stopped working, it is worth looking into.

Key Takeaways

• IRMAA can increase Medicare Part B premiums for people considered higher-income earners.

• Your 2026 Medicare Part B premium will be based on your 2024 tax return.

• A lower current income may allow you to appeal using Social Security Form SSA-44.

• Report expected income accurately because underestimating it can lead to later billing.

What Is IRMAA?

Many people do not pay a premium for Medicare Part A. Medicare Part B is different. Most people pay a monthly Part B premium unless they receive extra help through the state where they live.

For 2026, the standard Medicare Part B premium discussed here is $202.90 per month. But if Medicare considers you a higher-income earner based on your tax return, you may be charged more than that amount because of IRMAA.

That extra charge can feel frustrating, especially when the income Medicare used to calculate your premium does not match your income today.

Why Your 2026 Medicare Premium May Be Based on Old Income

Medicare generally determines your 2026 Part B premium using your income tax return from two years earlier. That means your 2026 premium may be based on your 2024 tax return.

This is where the problem often comes in. You may have been working in 2024 and earning a higher income. By 2026, you may be retired, working less, or no longer receiving the same income. Yet your premium can still reflect the income you had while working.

If your income has genuinely decreased, you do not simply have to accept that higher Medicare premium without asking for a review.

You May Be Able to Appeal Your IRMAA Decision

If your income is lower now than the income shown on the tax return Medicare used, you have the right to appeal your IRMAA-related premium.

The form used for this is Social Security Form SSA-44, officially called the Medicare Income-Related Monthly Adjustment Amount Life-Changing Event form. You can access it through the Social Security Administration's SSA-44 form page.

The process is straightforward:

1. Complete Social Security Form SSA-44.

2. Provide the requested income information showing that your income has been reduced.

3. Submit the form to your local Social Security office.

4. Wait for Social Security to review whether your Medicare premium can be lowered.

There is no cost to file this appeal. If approved, Social Security may reduce the additional amount you are paying for Medicare Part B.

Be Honest About Your Expected Income

One important caution: make sure the income amount you report is realistic and accurate.

If you successfully appeal your premium based on an expected lower income but later earn more than you claimed, you could be billed for the amount that was reduced. It is always better to provide a careful, truthful estimate than to underestimate your income just to lower the premium.

The goal is not to avoid a premium you truly owe. The goal is to make sure your Medicare Part B premium reflects your current financial situation rather than income from a time when you were still working.

Do Not Let a Higher Medicare Premium Cause Unnecessary Stress

Retirement brings enough changes without finding out that Medicare is using an outdated income picture to determine your premium. If your income has dropped since the tax year Medicare is using, take a closer look at your IRMAA notice and consider filing Form SSA-44.

Sometimes one form and a conversation with Social Security can make a meaningful difference in what you pay each month.

For Medicare questions or help understanding your options, reach out to Jessalyn Pito at 203-206-0848. Services are complimentary.