Why IRMAA Matters

*The Part D amount shown is the IRMAA surcharge only. It is added to the premium charged by your Part D prescription drug plan.

Source: Centers for Medicare & Medicaid Services (CMS), 2026 Medicare Parts B and D premiums and Social Security Administration (SSA).

What can affect your IRMAA?

Your Medicare-related income can come from more places than you might expect. Depending on your circumstances, it may include:

1. Wages or other earned income

2. Pension income

3. Social Security benefits

4. Withdrawals from retirement accounts

5. Interest and dividends

6. Capital gains

7. Other taxable income

   
   

A large one-time income event can also potentially affect your IRMAA in a future year. For example, selling an investment or taking a substantial retirement account distribution could increase the income used in determining your Medicare premiums. That doesn't necessarily mean you should avoid these transactions. Rather, it means that Medicare premiums can be one factor worth understanding when making retirement income decisions.

IRMAA is not a tax

IRMAA is sometimes confused with an additional tax. It is not. IRMAA is an adjustment to your Medicare Part B and Part D premiums based on income.

And because the calculation generally uses tax-return information from two years earlier, there can be a significant time gap between an income event and its potential effect on Medicare premiums.

What if your income has changed?

The income used by Medicare may not always reflect your current financial circumstances. For example, certain qualifying life-changing events—such as retirement or the loss of a pension—may allow you to request that Social Security reconsider an IRMAA determination. If you believe your IRMAA determination doesn't reflect your current circumstances, you can contact the Social Security Administration to learn whether you may qualify for a reconsideration.

A consideration in your retirement income plan

IRMAA is just one piece of the retirement income picture, but it can be an important one. Understanding how Medicare premiums are determined may help you have more informed conversations with your financial advisor, tax professional, and Medicare representative. Your retirement income decisions can have tax and Medicare-related consequences, so it's important to consider your individual circumstances before making financial decisions.

Important: This information is provided for educational purposes only and is not intended to provide tax, legal, Medicare, or investment advice. IRMAA rules, income thresholds, and Medicare premiums may change. Your individual circumstances may produce different results. Please consult the appropriate qualified professional regarding your specific situation. All information has been obtained from sources believed to be reliable, but its accuracy is not guaranteed.  There is no representation or warranty as to the current accuracy, reliability, or completeness of, nor liability for, decisions based on such information and it should not be relied on as such.

Apex Investment Group, LLC (“Apex Investment Group”) is a registered investment advisor. Advisory services are only offered to clients or prospective clients where Apex Investment Group and its representatives are properly licensed or exempt from licensure.”