Part D IRMAA is an extra monthly charge added to your Medicare prescription drug premium if your income exceeds a certain threshold. IRMAA stands for Income-Related Monthly Adjustment Amount, and it kicks in for individuals earning more than $106,000 or married couples filing jointly earning more than $212,000 (based on 2025 figures). Only about 8% of people with Medicare Part D pay this surcharge.
How Your Income Is Calculated
Social Security determines your IRMAA using your modified adjusted gross income, or MAGI. This is a simple calculation: your adjusted gross income (line 11 on your 1040 tax form) plus any tax-exempt interest income (line 2a). That second piece catches people off guard. Municipal bond interest, for example, doesn’t count as taxable income, but it absolutely counts toward your IRMAA threshold.
The key detail most people miss is the two-year lookback. Social Security uses your tax return from two years prior to set your current surcharge. So your 2023 tax return determines what you pay in 2025, and your 2024 return determines your 2026 IRMAA. A one-time spike in income, like selling a property or converting a traditional IRA to a Roth, can trigger a surcharge two years later even if your income has since dropped.
2025 and 2026 Surcharge Amounts
The surcharge is added on top of whatever your Part D plan already charges. It ranges from roughly $14 to $91 per month depending on your income bracket. Here are the current and upcoming rates.
2025 Rates for Individuals
- $106,001 to $133,000: $13.70/month
- $133,001 to $167,000: $35.30/month
- $167,001 to $200,000: $57.00/month
- $200,001 to $499,999: $78.60/month
- $500,000 or more: $85.80/month
2025 Rates for Married Filing Jointly
- $212,001 to $266,000: $13.70/month
- $266,001 to $334,000: $35.30/month
- $334,001 to $400,000: $57.00/month
- $400,001 to $749,999: $78.60/month
- $750,000 or more: $85.80/month
2026 Rates
The thresholds rise slightly for 2026. For individuals, the first bracket starts at $109,001, and the surcharges range from $14.50 to $91.00 per month. For married couples filing jointly, the first bracket starts at $218,001.
If you’re married filing separately, the brackets are much less forgiving. In 2025, any income above $106,000 jumps straight to $78.60 per month, with only one higher tier at $394,000. This filing status gets essentially two brackets instead of five.
How the Surcharge Is Collected
You don’t pay Part D IRMAA to your drug plan. Social Security deducts it directly from your monthly benefit payment, regardless of how you normally pay your plan premium. If the surcharge is more than your Social Security payment, or you don’t receive Social Security yet, you’ll get a separate bill from the Centers for Medicare & Medicaid Services or the Railroad Retirement Board.
This matters because falling behind on payment has real consequences. Medicare allows a three-month grace period for unpaid Part D IRMAA. After that, Medicare instructs your plan to disenroll you. You’ll receive a written notice within 10 days of that decision. If you’re enrolled in a Medicare Advantage plan that includes drug coverage, losing your Part D for nonpayment can mean losing your entire Medicare Advantage plan.
It Applies to Medicare Advantage Too
Part D IRMAA isn’t limited to standalone prescription drug plans. If you have a Medicare Advantage plan that includes drug coverage (sometimes called an MA-PD plan), you still owe the surcharge. The amount is the same regardless of which type of plan you choose. Switching from a standalone Part D plan to a Medicare Advantage plan with drug coverage won’t help you avoid it.
It’s also worth noting that Part D IRMAA is separate from Part B IRMAA. Part B has its own income-related surcharge for medical coverage, and you can owe both simultaneously. The income thresholds are the same, but the dollar amounts differ.
How to Appeal or Reduce Your IRMAA
If your income has dropped significantly since the tax year Social Security is using, you can request a reduction by filing Form SSA-44 with Social Security. You’ll need to demonstrate a qualifying life-changing event:
- Marriage, divorce, or death of a spouse
- You or your spouse stopped working or reduced hours
- Loss of income-producing property due to disaster, arson, fraud, or theft (not a voluntary sale)
- Loss of pension income from a terminated or reorganized employer pension plan
- Employer settlement payment from a bankrupt or reorganizing employer
Social Security will then use your more recent (or expected) income to recalculate the surcharge. This is particularly useful for people who have just retired. If your 2023 return showed a full year of salary but you stopped working in 2024, you can file SSA-44 to have your 2025 IRMAA based on your actual retirement income instead.
A one-time income event like a large capital gain or Roth conversion does not qualify as a life-changing event. In that case, you’ll pay the higher surcharge for the year it affects, and it will drop back down automatically once the two-year lookback window moves past that tax return.
Strategies That Reduce Exposure
Because IRMAA is based on MAGI, anything that lowers your adjusted gross income or keeps tax-exempt interest down can help. Spreading large Roth conversions across multiple years instead of doing one big conversion keeps you from jumping into a higher bracket. Timing the sale of appreciated assets across tax years works similarly.
If you’re close to a threshold, even small amounts matter. Being $1 over the $106,000 line (for individuals in 2025) triggers $13.70 per month, or about $164 per year. That’s not devastating, but crossing from one bracket to the next can add hundreds of dollars annually. Charitable donations from an IRA (qualified charitable distributions) reduce your AGI dollar for dollar if you’re 70½ or older, which can be enough to keep you under a bracket line.