IRMAA lasts for one calendar year at a time. Each January, Social Security recalculates whether you owe the surcharge based on your tax return from two years prior. So if your income drops, the surcharge can disappear the following year, but there’s always a two-year lag between earning the income and paying the higher premium.
How the Annual Cycle Works
IRMAA (Income-Related Monthly Adjustment Amount) is not a permanent status. It’s a year-by-year determination that Social Security makes by checking your modified adjusted gross income from your IRS tax return filed two years earlier. For 2025 premiums, Social Security looked at your 2023 tax return. For 2026, they’ll use your 2024 return.
This means IRMAA can last just one year if the income spike that triggered it was temporary. Sold a house, cashed out a large retirement account, or had a one-time capital gain? You’ll pay the surcharge for the year that corresponds to that tax return, then it drops off once the next year’s determination uses a return with lower income. On the other hand, if your income stays above the threshold year after year, IRMAA stays with you for as long as that’s the case.
The Two-Year Delay
The two-year look-back is the detail that catches most people off guard. If you retire in 2025 and your income drops significantly, you won’t see relief in your Medicare premiums until 2027, because your 2025 tax return won’t be used for IRMAA calculations until then. Your 2026 premiums are still based on your higher 2024 earnings.
This lag means that even after your financial situation changes, you could be paying the surcharge for up to two additional years unless you take action through the appeal process (more on that below).
2025 Income Thresholds
Whether you pay IRMAA at all depends on where your income falls. For 2025, the Part B thresholds work like this:
- No surcharge: Individual income at or below $106,000 (joint filers at or below $212,000). You pay the standard $185/month Part B premium.
- First tier: Individual income $106,001 to $133,000 (joint $212,001 to $266,000). Your Part B premium rises to $259/month.
- Second tier: Individual income $133,001 to $167,000 (joint $266,001 to $334,000). Premium: $370/month.
- Third tier: Individual income $167,001 to $200,000 (joint $334,001 to $400,000). Premium: $480.90/month.
- Fourth tier: Individual income $200,001 to $499,999 (joint $400,001 to $749,999). Premium: $591.90/month.
- Highest tier: Individual income $500,000 or more (joint $750,000 or more). Premium: $628.90/month.
Part D prescription drug coverage has its own IRMAA surcharge using the same income brackets. At the lowest affected tier, you’d pay an extra $13.70 per month on top of your plan’s premium. At the highest tier, it’s $85.80 extra per month. Combined, the Part B and Part D surcharges at the top bracket add more than $500 per month to your Medicare costs.
People who are married but file separately face a compressed bracket structure with only three tiers, and the surcharge jumps to near-maximum levels once income exceeds $106,000.
How to End IRMAA Early
You don’t have to wait out the two-year lag if your income dropped because of a qualifying life-changing event. Social Security recognizes eight specific situations that let you request a new determination using more recent income instead of the two-year-old tax return:
- Death of a spouse
- Marriage
- Divorce or annulment
- Work reduction or stoppage (including retirement)
- Loss of income-producing property (due to disaster, fraud, or similar events)
- Loss of an employer pension
- Receipt of a settlement from a current or former employer
To request this, you file Form SSA-44 with Social Security, along with documentation showing both the life-changing event and your reduced income. If approved, Social Security will use your current or more recent income to recalculate your premium, potentially eliminating the surcharge mid-year. This is the fastest way to stop paying IRMAA if your circumstances have genuinely changed.
One important limitation: a simple drop in investment returns or a bad year in the stock market doesn’t qualify. The event has to fit one of the categories above.
When You’ll Find Out Each Year
Social Security sends your tax information to the IRS annually to check whether your income exceeds the IRMAA thresholds. If it does, you’ll receive a notice explaining the surcharge amount before the new premium year begins. This notice arrives in late fall, typically before January premiums take effect.
If you believe the determination is wrong, perhaps because the IRS data was outdated or incorrect, you can contact Social Security to request a correction. You can also appeal if you’ve experienced one of the qualifying life-changing events and haven’t yet filed an SSA-44. The key is acting quickly, since premiums start being deducted in January and refunds for overpayment take time to process.
Planning Around the Surcharge
Because IRMAA resets every year based on a specific tax return, strategic income timing can make a real difference. If you’re approaching Medicare eligibility, the income you report in the two years before enrollment directly determines your initial premiums. Large Roth conversions, property sales, or retirement account withdrawals in those years can push you into a higher bracket for the corresponding premium year.
Spreading taxable events across multiple years, or timing them for years when you’re already above a threshold, can keep you from jumping into the next surcharge tier. Even a few dollars over a bracket boundary triggers the full surcharge for that tier, so knowing exactly where the lines fall matters. For 2025, that first threshold sits at $106,000 for individual filers and $212,000 for joint filers. Staying just below those numbers saves you $888 per year in Part B surcharges alone.