Received an IRMAA Notice? What to Do in the Next 60 Days

The Social Security Administration sends an "Initial IRMAA Determination" notice when your income triggers extra Medicare premiums. Here's how to read it, verify it's accurate, and decide whether to appeal — before the 60-day window closes.

What is the IRMAA notice?

The notice is officially called the Initial IRMAA Determination.³ It comes from SSA — not CMS or your Medicare plan — because SSA administers premium collection for Part B and coordinates Part D surcharges. You'll receive it by mail, typically in November or December for the following year's premiums, or within weeks of enrolling in Medicare if your income triggers IRMAA at enrollment.

The notice contains:

• Your 2024 Modified Adjusted Gross Income (MAGI) as SSA received it from the IRS
• Which IRMAA surcharge tier you fall into for 2026
• The extra monthly dollar amount added to your Part B premium
• The extra monthly amount for Part D (billed separately to your plan if you have standalone Part D, or adjusted within your Medicare Advantage plan premium)
• Your right to appeal and the 60-day deadline

Existing enrollees receive a related notice — the "Medicare Income-Related Monthly Adjustment Amount Notice"³ — each year when their surcharge tier changes. The same triage steps apply.

Your 2026 IRMAA surcharge: confirm your tier

SSA calculates your tier based on your 2024 MAGI. Verify the notice placed you in the correct bracket:

Surcharges are per person. Both Medicare-enrolled spouses each pay the surcharge on the same joint MAGI. Base Part B premium: $202.90/mo. Source: CMS 2026 Medicare Part B Fact Sheet.¹

Use the IRMAA bracket calculator to confirm your tier by entering your 2024 MAGI and filing status.

Step 1 — Verify SSA used the correct income figure

Before deciding whether to appeal, confirm that the MAGI in your notice matches your actual 2024 tax return. SSA receives income data from the IRS through an annual data exchange — but errors occur.

Pull your 2024 Form 1040 and calculate your IRMAA MAGI: line 11 (AGI) plus line 2a (tax-exempt interest). That sum is what SSA should have used. Common reasons for a mismatch:

• Late-filed return: If your 2024 return wasn't filed when SSA ran the IRS data pull, SSA may have used your 2022 or 2023 income instead — which could be higher or lower.
• Amended return: If you filed a 2024 amended return (Form 1040-X) that reduced your MAGI, SSA may not have the updated figure yet.
• IRS data transfer error: Rare but documented — the IRS occasionally transmits incorrect data.

If the income SSA used is incorrect, do not file Form SSA-44. Instead, file Form SSA-561 (Request for Reconsideration),² which challenges the accuracy of the determination itself. Attach a copy of your actual 2024 Form 1040 and any amended return. SSA is required to correct the record once the discrepancy is documented.

Step 2 — Check whether a life-changing event qualifies you for an appeal

If the income SSA used is correct — but your financial situation has changed significantly since then — you may qualify for a redetermination using more recent income. This is Form SSA-44, and it applies only when the income drop was caused by one of seven qualifying life-changing events:

• Retirement or a significant reduction in work hours or salary
• Marriage
• Divorce or annulment
• Death of a spouse
• Involuntary loss of income-producing property (disaster, theft, fraud — not a voluntary sale)
• Loss or reduction of pension income

The most common qualifying event for new Medicare enrollees: work stoppage. If you retired in 2024 or 2025, your 2026 Medicare premium is based on your working-year income — but your current income may be far lower. A successful SSA-44 appeal can save $1,148 to $6,936 per person per year.

For the complete process — documentation, income estimation, the Tom worked example ($4,619/year in savings) — see the IRMAA appeal guide.

What does NOT qualify for SSA-44: Roth conversions, capital gain realizations, investment decisions, and voluntary business or property sales do not trigger an appeal right — even if they were one-time events. If your 2024 income spike came from portfolio activity, Step 3 is your path forward.

Step 3 — If IRMAA is correct and no qualifying event applies

Accept the 2026 surcharge and focus energy on managing future exposure. The two-year look-back means 2026 premiums are already fixed — but 2027 premiums will be based on 2025 income, and 2028 on 2026 income. There is still time to act on both.

The most effective levers for future IRMAA reduction:

• Qualified Charitable Distributions (QCDs): Up to $111,000/person excludes IRA distributions from MAGI entirely and counts toward your RMD. Full details: 7 IRMAA reduction strategies.
• Roth conversion timing: Converting before age 65 falls entirely outside the Medicare look-back window and reduces future RMD income. Full details: Roth conversion + IRMAA guide.
• Capital gain deferral and harvesting: Spreading realizations across low-income years can keep you in a lower tier. See: capital gains and IRMAA.
• RMD modeling: Large RMDs starting at 73 (or 75 for those born 1960+) can permanently push you up tiers. Pre-RMD Roth conversions reduce that exposure. See: RMDs and IRMAA.

The married-couple issue

IRMAA is assessed per person on joint MAGI. If both you and your spouse have Medicare, you may each owe the surcharge. A household with two Medicare enrollees at Tier 2 pays $2,884 × 2 = $5,768/year in extra premiums. The notice may name both of you separately or arrive as two distinct letters.

Also: married filing separately (MFS) is almost never better for IRMAA. The MFS income thresholds are far less generous than joint-filer thresholds — the same combined household income can trigger much higher surcharges under MFS than under joint filing. Don't change your filing status to reduce IRMAA without running the full numbers first. See: Medicare for married couples.

What to do before the 60-day window closes

1. Pull your 2024 Form 1040. Verify that SSA's income figure matches your actual 2024 MAGI (AGI + tax-exempt interest). If it's wrong, file SSA-561 immediately.
2. Check for a qualifying event. If you retired, changed marital status, or lost pension income after your 2024 tax year, you may qualify for SSA-44 — even if the income figure is accurate.
3. If appealing, file promptly. SSA-561 and SSA-44 can both be initiated online at SSA.gov/medicare/lower-irmaa or mailed to your local SSA office. Don't wait until day 58.
4. If not appealing, model the next two years. Your 2027 surcharge is based on 2025 income — which is still partially in your control. Start there.

Sources

1. CMS — 2026 Medicare Parts B Premiums and Deductibles (Fact Sheet). Part B base premium $202.90/mo; full IRMAA surcharge amounts by tier for Part B and Part D. Published November 14, 2025.
2. SSA — Form SSA-561, Request for Reconsideration. Used to dispute an SSA determination when the underlying income data is incorrect. Distinct from SSA-44, which is for income reduction caused by a qualifying life event.
3. Medicare.gov — Initial IRMAA Determination Notice. Official description of the notice SSA sends when IRMAA first applies to a Medicare enrollee. Includes explanation of the notice contents and appeal rights.
4. SSA.gov — Request to Lower an IRMAA Surcharge. Official landing page for both SSA-44 (life-changing event) and reconsideration requests. Includes online filing and qualifying event list.
5. SSA POMS HI 01101.020 — IRMAA Sliding Scale Tables. Updated December 2025. Authoritative source for 2026 IRMAA income thresholds and surcharge amounts by filing status, including MFS brackets.

IRMAA surcharge amounts and income thresholds verified against CMS 2026 Medicare Part B Fact Sheet and SSA POMS (December 2025). Appeal deadline confirmed at 60 days from receipt per SSA policy. QCD limit $111,000/person per IRS Rev. Proc. 2025-32. Values current as of June 2026.