Medicare IRMAA: Why Did My Premium Go Up and Can I Appeal?

Quick Answer

IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums for higher-income beneficiaries. In 2026, IRMAA applies when your modified adjusted gross income from two years prior exceeds certain thresholds.

 This 2-year lookback is why IRMAA surprises many retirees: a high-income year at age 63 (from a Roth conversion, business sale, or final working year) can produce an unexpected Medicare surcharge at 65. 

If your income has dropped due to a qualifying life-changing event, you can ask SSA to use a more recent year’s income instead. 

Qualifying Life-Changing Events for IRMAA Appeal

SSA will accept an IRMAA appeal (Form SSA-44) if you experienced one of the following:

• Marriage, divorce, or annulment
• Death of a spouse
• Work stoppage or reduction (including retirement)
• Loss of income-producing property (not from a sale)
• Loss or reduction of pension income
• Receipt of a settlement from an employer due to closure or bankruptcy 

For South Jersey retirees, the most common triggers are retirement (earned income drops) and death of a spouse (household income decreases).

 The WealthCare Perspective

IRMAA is one of several places where Roth conversion planning, retirement income sequencing, and Medicare cost management intersect. We regularly help clients: 

• Project IRMAA exposure before a large income event (such as a Roth conversion or asset sale)
• Structure Roth conversions to stay below IRMAA thresholds
• Prepare and file an IRMAA appeal when a qualifying life event applies

 This coordination — between your income plan, tax strategy, and Medicare costs — is part of what the WealthCare Process is designed to address before problems arise. 

Common Mistakes

• Large Roth conversions in a single year without checking IRMAA bracket exposure
• Not appealing after retirement when income has clearly dropped
• Waiting too long to appeal — file the SSA-44 form as soon as the qualifying event occurs

What to Do Next

If you believe you qualify for an IRMAA reduction, contact our team. We can help you organize documentation and coordinate with your CPA on the income projection SSA will need to process your appeal. Contact us today or learn more about our Social Security Planning services here.