You retired in March. Your paycheck stopped. And then a letter showed up from Social Security explaining that your Medicare premium will be several hundred dollars a month higher than the standard amount, because of how much you earn.
Except you don't earn that anymore. That was the old you — the one with the salary.
This is IRMAA, and it catches an enormous number of people in their first year of retirement. The good news is that there's a specific form for exactly this situation, and most people who qualify never file it because nobody told them it exists.
What IRMAA actually is
IRMAA stands for the income-related monthly adjustment amount. It's a surcharge added on top of your standard Medicare Part B and Part D premiums once your income crosses certain thresholds.
It is not a separate bill. It's baked into what gets deducted from your Social Security check, or into the invoice Medicare sends you, so it can take a minute to even understand what you're looking at.
In 2026, the standard Part B premium is $202.90 a month. The first IRMAA tier kicks in at around $109,000 of income for a single filer and roughly $218,000 for a married couple filing jointly, and there are five tiers above that. At the first tier, the Part B surcharge is about $81 a month per person. At the top tier it climbs to roughly $487 a month per person — and Part D carries its own separate surcharge on top of whatever your drug plan already costs.
For a couple, that's doubled. Both spouses pay their own surcharge based on the same joint income.
The part that makes no sense until someone explains it
Medicare doesn't look at what you make now. It looks at your tax return from two years ago.
So your 2026 premium is set using your 2024 tax return — the one from back when you were still working, still getting bonuses, maybe still selling something. Social Security gets that figure from the IRS and applies it.
Which means the system is, by design, always looking at a version of your finances that may no longer exist. For most people that lag doesn't matter much. For someone who just retired, it's the whole problem.
One more thing worth knowing: IRMAA is a cliff, not a slope. There's no gentle phase-in. Go one dollar over a threshold and you owe the full surcharge for that tier, all year.
Form SSA-44 — the fix nobody mentions
If your income dropped because of a qualifying life-changing event, you can ask Social Security to use your current or expected income instead of that two-year-old return. The form is SSA-44, titled "Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event."
SSA recognizes a specific list of events. Generally they include:
- Work stoppage — which is what retirement is, in SSA's language
- Work reduction — cutting back to part-time counts
- Marriage
- Divorce or annulment
- Death of a spouse
- Loss of income-producing property — through a disaster or other event outside your control
- Loss of pension income
- An employer settlement payment due to the employer's closure or bankruptcy
You pick the event, write in the year your income changed, estimate your modified adjusted gross income for that year, and attach proof. A letter from your employer confirming your retirement date, a signed statement, a more recent tax return, a benefit award letter — the form itself walks through what's acceptable for each event type.
You can file it at your local Social Security office, by mail, or by fax. There's no filing fee, and you don't need anyone's permission to submit it.
A one-time spike in income is not a life-changing event. A large capital gain, an inherited IRA distribution, a Roth conversion, the sale of a house, an inheritance — these can all push you over an IRMAA threshold, and none of them qualifies for an SSA-44 reduction, because your income didn't permanently change. It went up once. That surcharge typically has to be ridden out until the two-year lookback catches up. If you disagree with the determination itself — wrong figures, an amended return SSA hasn't seen, an IRS error — that's a different process: a request for reconsideration, generally filed within 60 days of the date on the notice. Timelines, thresholds, and qualifying events change, so confirm the current rules with SSA directly and talk to a CPA or licensed financial professional about your own numbers.
Timing: file early, and plan to file again
You don't have to wait for the surcharge notice to arrive. If you know your income is about to drop — you've set a retirement date, you've given notice — you can file SSA-44 with an estimate of what you expect to make.
And this is the part that surprises people: IRMAA is determined year by year. Your 2027 premium will be set using your 2025 return, which may still be a working year. So one SSA-44 doesn't necessarily solve it forever. If the lookback still shows the old income next year, you may need to file again for the following year.
Put a note in your calendar for late fall, when the new premium notices typically go out. Then check whether the number they used still reflects a person who exists.
What to have ready
- The determination notice from Social Security — the one with the premium amount and the tax year they used
- The tax return SSA based it on, so you can see what they saw
- Proof of the event: a retirement or separation letter from your employer, a death certificate, a divorce decree, a pension termination letter
- Your best estimate of modified adjusted gross income for the year the change took effect — and the year after, if you're filing ahead
- A record of when you submitted it, how, and to whom, including any confirmation or receipt
What to do next
Pull the notice out of the pile and find two things: the dollar amount and the tax year. Those two facts tell you whether you're looking at an IRMAA surcharge or just a standard premium.
Then ask whether anything on the SSA-44 list has happened to you since that tax year. If the answer is yes, download the form from ssa.gov, gather your proof, and send it. If the answer is no — if it was a one-time gain — check the calendar and know when it falls off.
Either way, build the surcharge into your first-year retirement budget rather than being ambushed by it in January.
Our Medicare Enrollment Checklist & Cover Letter and Medicare Plan Comparison Worksheet give you one place to keep enrollment dates, premium notices, and plan costs together while you sort this out. Both are in our Retirement bundle at lumeway.co/templates. They're organizational tools designed to help you prepare — not a substitute for advice from a licensed professional.
You retired from the job. Somebody should tell the paperwork.
This post is for general informational purposes only and is not legal, financial, tax, or medical advice. Medicare premiums, IRMAA thresholds and surcharge amounts, qualifying life-changing events, and appeal procedures are set by federal rule and change from year to year. Figures cited here reflect 2026 amounts and are not a guarantee of what you will be charged. Confirm current rules and amounts with the Social Security Administration or Medicare directly, and consult a licensed financial professional or CPA about your specific situation before making decisions based on this information.