# Your Medicare premium letter says you owe more because of income you no longer have

- URL: https://www.agentskillpacks.com/guides/irmaa-letter-medicare-premium-too-high
- Updated: 2026-10-21
- Book: The Year You Turn 65 by Nancy Whitaker (https://www.agentskillpacks.com/books/the-year-you-turn-65)

## Short answer

The higher premium is a surcharge called IRMAA, the Income-Related Monthly Adjustment Amount. Social Security sets it from your tax return from 2 years ago, so for 2026 that is generally tax year 2024. If you retired since then, your first Medicare year can be priced from a full salary. If your income dropped because of a life-changing event, such as stopping work or cutting your hours, you can ask Social Security to use a newer year with Form SSA-44. In 2026 the surcharge starts above $109,000 on an individual return or $218,000 on a joint return.

**The 2026 surcharge, based on your tax year 2024 return (CMS figures; these change every year)**

| Income, individual return | Income, joint return | Part B, monthly total | Part D surcharge, monthly |
| --- | --- | --- | --- |
| $109,000 or less | $218,000 or less | $202.90 (standard) | $0.00 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $60.40 |
| Above $205,000, under $500,000 | Above $410,000, under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |

## What to do with the letter today

Put the letter on the table. Don't pay it in a panic, and don't throw it out. Do these four things.

1. **Find the tax year on the letter.** For 2026, Social Security generally uses your tax year 2024 return.
2. **Ask whether your income dropped because of a life-changing event.** Retiring counts. So does a spouse retiring, or cutting back to part-time.
3. **Gather proof of the event and its date.** A letter from your employer is the kind of thing that helps. Ask Social Security what proof it needs for your case.
4. **Ask for Form SSA-44.** It asks Social Security to use a more recent year. Their page for it is SSA.gov/medicare/lower-irmaa.

If you think the income on the letter is simply wrong, that is a different route. Ask Social Security how to ask for a review.

## How to send Form SSA-44

[Social Security's page for lowering IRMAA](https://www.ssa.gov/medicare/lower-irmaa) gives four ways to ask.

- **Online.** Sign in to your Social Security account, then fill out and upload Form SSA-44.
- **By fax or mail.** Fill out the paper Form SSA-44 and send it, with your proof, to a Social Security office.
- **In person.** Sign in and make an appointment.
- **By phone.** Call 1-800-772-1213 (TTY 1-800-325-0778) and say you want to lower your IRMAA because of a life-changing event.

What proof to send? Social Security's [rules for higher-income beneficiaries](https://www.ssa.gov/benefits/medicare/medicare-premiums.html) say it needs papers that show the event and the drop in your income. Examples it gives are a death certificate or a letter from your employer about your retirement. If you filed a federal tax return for the year in question, it also needs your signed copy.

Two special cases have their own route:

- **You amended your tax return.** Call Social Security and say so. It needs a copy of the amended return and your receipt from the IRS.
- **Social Security used the older year, 2023.** If you filed a 2024 return, or did not need to file one, call or visit an office so it can update its records.

## If you want to appeal instead

A new decision for a life-changing event is not an appeal. Social Security says you don't need to file an appeal for that.

If you simply disagree with the decision, you have the right to appeal. Social Security says the fastest way is online. You can also use Form SSA-561-U2, a Request for Reconsideration, or contact your local office. If you think the income figure from the IRS is wrong, Social Security says you must correct it with the IRS.

## The retirement that the letter doesn't know about

The book's own example goes like this. You worked full time through 2024. You retired at the end of 2025. In 2026, your income is about half of what it was.

Then the letter arrives. Your Part B premium for 2026 is $405.80 a month, twice the standard amount. You haven't had a paycheck in months.

It feels like a mistake. It isn't, at least not yet. The rule looks back two years. It was built from a tax return that describes a life you no longer live.

If the letter is the first you have heard of this surcharge, that is why it feels like an accusation instead of a rule.

## How the surcharge is built

The official name is the Income-Related Monthly Adjustment Amount, IRMAA for short. There is one for Part B and a second one for drug coverage, Part D.

Social Security decides who pays it, using income from the IRS. The income it uses is your modified adjusted gross income, which for this purpose means your adjusted gross income plus any tax-exempt interest.

The table above has the 2026 levels. The [CMS fact sheet on 2026 premiums](https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles) sets them each year. Each step is set as a share of what Part B costs, from 35% of the total cost up to 85%.

Married and filing separately? That table has only three levels. At $109,000 or less you pay the standard $202.90 and no Part D surcharge. Above $109,000 and under $391,000, it jumps to $649.20 and $83.30.

The Part D surcharge goes to Medicare, not to your plan. You pay it even if an employer pays your plan premiums. If you don't pay it, you could lose your drug coverage. And if you pay Part B by bill, the surcharge means a bill every month instead of every 3 months.

For 2027, one figure was known when the book was written: the Part D surcharge starts above $111,000 individual or $222,000 joint. The [Medicare & You 2027 handbook](https://www.medicare.gov/publications/10050-medicare-and-you.pdf) has it, and we will not guess the rest.

## Where the book covers the surcharge

This is the problem [The Year You Turn 65](/books/the-year-you-turn-65) was written for. Nancy Whitaker's book explains the surcharge in plain words and gives you a page to track your request.

**The Surcharge Built From an Old Tax Return** has the full 2026 table, the married-filing-separately rows, the list of life-changing events, the 2027 figure and a fill-in page for the tax year used, your event, your proof and the date you sent Form SSA-44.

**The Doors That Open Every Year** shows when the new figures come out each year. CMS normally releases the next year's Part B numbers in November.

The book is not affiliated with Medicare or Social Security, and it is not tax advice. Social Security is the one that can look at your own file and change the decision. Your State Health Insurance Assistance Program (SHIP) gives free counseling if the letter does not make sense to you.

## Where this is in the book

- The Surcharge Built From an Old Tax Return
- The Doors That Open Every Year

Kindle: https://www.amazon.com/dp/B0HLB95HY6
Paperback: https://www.amazon.com/dp/B0HLBWL7D4

Links go to Amazon. ToolGenX publishes this book under a pen name and earns from every sale.

Not affiliated with Medicare, the Social Security Administration, or any government agency. This book lays out published rules and dates. It is not legal, tax, medical or financial advice. For your own record, call your State Health Insurance Assistance Program (SHIP) or Social Security.

## Is the book for you?

- Yes, if You retired in the last two years and just got a higher Part B premium
- Yes, if Your spouse stopped working and the joint return no longer looks like your life
- Yes, if You want to know which tax year Social Security used and why
- Skip it if Your income is still as high as the year Social Security used (the surcharge may be right)
- Skip it if You want tax planning to lower future income (ask a tax preparer for that)

## FAQ

### What year's income does Medicare use for IRMAA?

Your tax return from 2 years ago. For 2026, that is generally the return you filed in 2025 for tax year 2024. If the IRS only has the 2023 return, Social Security uses that one.

### What counts as a life-changing event for IRMAA?

As Social Security lists them: marriage, divorce or a spouse's death; you or your spouse stopping work or cutting work hours; losing income-producing property in a disaster; a pension plan stopping, ending or being reorganized; or an employer settlement because of its closure, bankruptcy or reorganization.

### Does retirement count for Form SSA-44?

Yes. Stopping work fits the second item on Social Security's list. So does a spouse's retirement, and cutting back to part-time work. Keep proof of the event and its date, such as a letter from your employer.

### What are the 2026 IRMAA income limits?

For 2026, based on tax year 2024, the standard Part B premium of $202.90 applies at $109,000 or less on an individual return, or $218,000 or less on a joint return. Above that, the Part B total runs from $284.10 to $689.90 a month, with a Part D surcharge from $14.50 to $91.00.

### What if I think Social Security used the wrong income?

The life-changing event route is for income that fell. If the tax information is wrong or the wrong year was used, Medicare points you to the same page, SSA.gov/medicare/lower-irmaa. Ask Social Security how to ask for a review.

### Does a Roth conversion or a home sale count as a life-changing event?

Neither is on Social Security's list. The list covers marriage, divorce or a spouse's death, stopping or cutting back work, losing income-producing property to a disaster or other event beyond your control, a pension plan ending or being reorganized, and an employer settlement after a closure or bankruptcy. If your income rose for another reason, ask Social Security or a tax preparer before you file.