Jar of money from income for health insurance medicare premium

Paying Too Much for Medicare? How to Lower Your Premiums

Medicare coverage is broken up into different parts. Part A covers your care when you are hospitalized. Part B coverage includes out-patient care, doctors visits, and preventive services. Part D covers most prescription drugs.

You must pay a monthly premium for Medicare Part B and Part D coverage. Did you know that what you pay is actually based on your income level? This blog explains how your monthly premium amount is determined, what you will pay for Medicare in 2024, and what to do if your income has changed.

What is IRMAA?

If your household income is over a certain level, Medicare may require you to pay more on top of the normal Part B and Part D premiums. This is called the “Income-Related Monthly Adjustment Amount,” or IRMAA.

How is my Medicare premium amount determined?

Medicare determines your IRMAA payment based on your reported income from two years prior to the current year. For example, for 2024, your IRMAA payments are calculated based on your reported income in your 2022 tax return.

If the Social Security Administration (SSA) decides that you have to pay a higher premium, they will send you a notice called an “initial determination.”

If you receive Social Security benefits, SSA will automatically deduct your premiums from those benefits each month.

What will I pay for Medicare in 2024?

If you file an individual tax return, you may need to pay more for Medicare Parts B and D, if your income is more than $103,000. If you are married and file jointly with your spouse, you may need to pay more for Medicare Parts B and D, if your combined income is more than $206,000.

This chart shows what you will pay for Parts B and D in 2024:


If you file an individual tax returnIf you file married & joint tax returnIf you file married & separate tax returnYou pay for Part B (2024):You pay extra for Part D (2024):
And, your yearly income in 2022 (for what you pay in 2024) was:
$103,000 or less$206,000 or less$103,000 or less$174.70$0
above $103,000 up to $129,000above $206,000 up to $258,000Not applicable$244.60$12.90
above $129,000 up to $161,000above $258,000 up to $322,000Not applicable$349.40$33.30
above $161,000 up to $193,000above $322,000 up to $386,000Not applicable$454.20$53.80
above $193,000 and less than $500,000above $366,000 and less than $750,000above $103,000 and less than $397,000$559.00$74.20
$500,000 or above$750,000 and above$397,000 and above$594.00$81.00


What can I do if I think my premium is wrong?

If you think that SSA made a mistake in calculating your Medicare premium, you can follow the instructions in your notice of initial determination. This is the document that you received from SSA, telling you about your higher Medicare premium. You can request a new initial determination from SSA.

Medicare may have made a mistake in charging you a higher premium if you filed an amended tax return for the year that SSA used to make the IRMAA decision or if there was an error in IRS data used to determine your IRMAA amount.

What if my income has changed?

You can also apply for a new initial determination if you have experienced one or more “life-changing events” in the last two years that lowered your income. Medicare considers these to be life-changing events:

  1. Marriage
  2. Divorce or annulment
  3. Death of your spouse
  4. Work stoppage
  5. Work reduction
  6. Loss of income-producing property
  7. Loss of pension income
  8. Employer settlement payment

How can I request a refund because of a life-changing event?

If you have experienced one of these life-changing events and how have a lower income, there are several ways you can request an IRMAA refund from SSA.

First, you can fill out Medicare’s Form SSA-44, which will ask you to provide information about the life-changing event and the reduction in your income because of that event. Mail, fax, or deliver the form to your local SSA office.

You can also call SSA at 1-800-772-1213 and ask to lower your Medicare IRMAA. You can also call to schedule an in-person appointment at a local SSA office if you need help completing Form SSA-44.

For all of these options, you will need to provide evidence of the life-changing event and your reduction in income. If you mail or fax the Form SSA-44, you should attach any documents that show that you experienced a life-changing event and the reduction in income. If you schedule an in-person appointment at a local SSA office, you should bring any necessary documents with you to your appointment.

If my spouse and I are both covered by Medicare, do we both need to request a refund?

Yes, if you are married and your spouse is also covered by Medicare, your spouse should also apply for an IRMAA refund.

How long do IRMAA refunds take to be processed?

The length of time SSA takes to approve IRMAA refund requests varies depending on your request, and can take several months. However, once you receive a letter from SSA notifying you that you will receive an IRMAA refund, you should receive the refund within 30 days.

If 30 days have passed after receiving a refund letter and you have not received that refund, you should call SSA at 1-800-772-1213.

Can I appeal an IRMAA refund decision?

Yes, you have the right to make an appeal of an IRMAA decision. These appeals are called “reconsiderations.” There are two ways you can request a reconsideration.

First, you can complete SSA Form SSA-561-U2. This form will require you to explain why you disagree with SSA’s decision to charge you a higher Medicare premium.  You can mail or fax the form to your local SSA office.

You can also call SSA at 1-800-772-1213 to request this form or request an in-person appointment at your local SSA, where a representative will help you complete the form.

Learn more information about Medicare here.


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