An IRMAA letter from Social Security means your Medicare Part B premium, your Part D premium, or both will include an income-related monthly adjustment amount. That's an extra charge based on your income from a couple of years ago.
The letter is a formal decision, and you have options. Take ten minutes to check it, then decide which of three paths fits your situation.
What kind of letter you have
- Already on Medicare: you usually get a notice with your yearly cost-of-living information that explains IRMAA in detail. That notice is an initial determination with appeal rights (POMS HI 01101.035).
- New to Medicare: you may first get a pre-determination notice. It has no appeal rights. It invites you to contact Social Security within 10 days if you think the information is wrong. About 20 days later comes the initial determination, with appeal rights.
Under the federal regulation, the decision notice has to tell you: the decision, the income information used, the reason, what it means for you, and your right to ask for a reconsideration or a new initial determination (20 CFR 418.1315).
Check these five things first
- The tax year. For 2026 premiums it should be 2024, or 2023 if the IRS didn't have 2024.
- The MAGI. It should equal line 11 (adjusted gross income) plus line 2a (tax-exempt interest) on your Form 1040 for that year.
- Your filing status. Single, joint, separate and so on, as on that return.
- The tier. Compare your MAGI and status with the 2026 IRMAA brackets, paying attention to the exact edges.
- Part D. If you're charged a Part D IRMAA but have no drug coverage, call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). Social Security gets that information from CMS.
See if an SSA-44 could lower your IRMAA. Start the free IRMAA check →
Path 1: your income dropped because of a life-changing event
If you retired, cut back your hours, married, divorced, lost your spouse, or had one of the other qualifying events, ask Social Security to use a newer tax year. You can do that with Form SSA-44, by phone, or at an office. This is called a new initial determination. It's a fresh decision, not an appeal, and if you qualify there's no need to appeal (POMS HI 01120.001).
You can ask any time during the year your income drops. Start with the list of qualifying events, then follow the SSA-44 instructions.
Example: You're single, and your letter shows 2024 MAGI of $210,000. In 2026 you pay $649.20 for Part B and $83.30 on top of your drug plan. You retired in mid-2025. Your 2025 MAGI was $140,000, and 2026 won't be lower. Using 2025, you'd pay $405.80 and $37.50. That saves $289.20 a month, or $3,470.40 a year.
Path 2: the IRS numbers are wrong or out of date
- The IRS made an error: fix it with the IRS first. Its number is 1-800-829-1040. Once you have a letter from the IRS about the correction, go back to Social Security for a new decision. Social Security won't change it on appeal just because you say the IRS figure is wrong. It will dismiss that request and send you to the IRS (20 CFR 418.1330).
- You filed an amended return: call 1-800-772-1213. Social Security needs a copy of the amended return and the IRS's acknowledgment of it.
- They used a 3-year-old return: if you've filed the 2-year-old return, or didn't need to file one, call or visit a Social Security office. If you filed it, bring a signed copy. They'll update your record.
- Married filing separately but lived apart all year: call 1-800-772-1213 and say so. Don't use Form SSA-44 for this.
Path 3: you think Social Security got it wrong
If the IRS numbers are right but you believe the decision is wrong, request a reconsideration. That's the first level of appeal. One example from Social Security's manual: the IRS figure is correct, but the wrong IRMAA level was applied (POMS HI 01140.005).
The 60-day clock
You have 60 days from when you receive the notice to ask for reconsideration. Social Security assumes you received it 5 days after the date on the letter, unless you show otherwise (POMS HI 01140.001).
You can appeal online, mail or bring Form SSA-561-U2, or go to your local office. You can also appeal and file an SSA-44 at the same time, within the 60 days. See IRMAA appeal vs. SSA-44 for how the two fit together.
How the extra charge gets paid
- Part B: Social Security takes the Part B premium out of your monthly benefit. If the benefit isn't big enough, it takes what it can and bills you for the rest. If you don't get Social Security benefits, the Railroad Retirement Board, the Office of Personnel Management or CMS bills you instead.
- Part D: Social Security deducts the Part D IRMAA from your monthly payment, no matter how you pay your plan's premium. If it's more than your payment, or you don't get payments, you get a separate bill from CMS or the Railroad Retirement Board.
What not to do
- Don't let the 60 days slip if you think there's an error. An SSA-44 request follows its own timing, but the appeal window is only 60 days.
- Don't file SSA-44 for a one-time income spike. Capital gains from selling property, an IRA conversion, lottery or casino winnings, and cashing bonds are not life-changing events.
- Don't appeal only because the IRS figure is wrong. Go to the IRS first.
- Don't assume your request covers your spouse. Each person who pays IRMAA has to make their own request.
Want a quick read on your options? The free IRMAA and SSA-44 check takes the figures from your letter and shows whether an SSA-44 could help and how much it might save.