Most retirees are surprised to learn that Medicare premiums are not the same for everyone. Since 2007, people with higher incomes have paid extra through something called the Income Related Monthly Adjustment Amount (IRMAA). In simple terms, IRMAA is a surcharge added to your Medicare Part B and Part D premiums if your income is above certain levels. These surcharges are automatically deducted from your Social Security check.
When Did IRMAA Start?
IRMAA was created by Congress in the 2003 Medicare Modernization Act, and it took effect in 2007. At the time, the surcharge applied only to Medicare Part B (doctor visits, outpatient care).
The idea was straightforward: if your income was above a set threshold, you would pay more toward the cost of Medicare. For example, in 2007:
- Individuals earning $80,000 or less (couples $160,000 or less) paid the standard Part B premium of $93.50.
- Higher income groups paid more, with the top tier paying $161.40 per month.
| 2007 IRMAA Brackets | ||
| Individual MAGI | Couple MAGI | Part B Premium |
| $80,000 or less | $160,000 or less | $93.50 |
| $80,001-$100,000 | $160,001-$200,000 | $105.80 |
| $100,001-$150,000 | $200,001-$300,000 | $124.40 |
| $150,001 – $200,000 | $300,001 – $400,000 | $142.90 |
| Above $200,000 | Above $400,000 | $161.40 |
The Affordable Care Act Expands IRMAA
In 2011, the Affordable Care Act added IRMAA charges to Part D prescription drug coverage. That meant higher-income retirees not only paid more for doctor visits but also extra surcharges on drug plan premiums.
At the same time, premiums grew faster than income thresholds. While thresholds inched up only about 1.6%, the surcharges increased by over 17% between 2007 and 2011.
| 2011 IRMAA Brackets | |||
| Individual MAGI | Couple MAGI | Part B Premium | Part D Premium |
| $85,000 or below | $170,000 or below | $115.60 | Plan Premium |
| $85,001 – $107,000 | $170,001 – $214,000 | $161.50 | $12.00 |
| $107,001 – $160,000 | $214,001 – $320,000 | $230.70 | $31.00 |
| $160,001 – $213,000 | $320,001 – $426,000 | $299.90 | $51.10 |
| above $213,000 | above $426,000 | $369.10 | $69.10 |
Freezing and Changing the Brackets
- 2010s freeze: For years, IRMAA income brackets were frozen and did not rise with inflation. That meant more people got pulled in as incomes naturally grew.
- 2015 Budget Act: Congress locked the brackets in place until at least 2028.
- 2018 Budget Act: A new 5th IRMAA tier was added, hitting the highest-income retirees with even bigger surcharges.
| 2018 IRMAA Brackets | |||
| Individual MAGI | Couple MAGI | Part B Premium | Part D Premium |
| $85,000 or below | $170,000 or below | $134.00 | Plan Premium |
| $85,001 – $107,000 | $170,001 – $214,000 | $187.50 | $12.30 |
| $107,001 – $160,000 | $214,001 – $320,000 | $267.90 | $31.30 |
| $160,001 – $214,000 | $320,001 – $428,000 | $348.30 | $51.80 |
| above $214,000 | above $428,000 | $428.60 | $70.80 |
By 2019, the surcharge brackets stretched from about $85,000 for singles to $750,000 for couples, with monthly surcharges climbing steeply at each tier.
| 2019 IRMAA Brackets | |||
| Individual MAGI | Couple MAGI | Part B Premium | Part D Premium |
| $85,000 or below | $170,000 or below | $104.90 | Plan Premium |
| $85,001 – $107,000 | $170,001 – $214,000 | $189.60 | $12.34 |
| $107,001 – $133,500 | $214,001 – $267,000 | $270.90 | $31.50 |
| $133,500 – $160,000 | $267,001 – $320,000 | $352.20 | $51.40 |
| $160,001 – $500,000 | $320,001 – $750,000 | $433.40 | $70.90 |
| Above $500,000 | Above $750,000 | $428.60 | $77.40 |
Where IRMAA Stands Today (2025)
In 2025, the first income threshold for IRMAA begins at about $106,000 for individuals and $212,000 for couples.
- The lowest IRMAA surcharge adds roughly $74 per month ($259 for Part B and $13.70 for Part D).
- The highest bracket pushes Part B to $628.90 per month, plus another $85.80 for Part D.
This means that retirees with higher incomes may pay over $700 per month per person for Medicare premiums.
| 2025 IRMAA Brackets | |||
| Individual MAGI | Couple MAGI | Part B Premium | Part D Premium |
| < $106,000 | < 212,000 | $185.00 | Premium (varies) |
| $106,000 – $133000 | $212,000 – $266,000 | $259.00 | $13.70 |
| $133,000 – $167,000 | $266,000 – $334,000 | $370.00 | $35.30 |
| $167,000 – 200,000 | $334,000 – $400,000 | $480.90 | $57.00 |
| 200,000 – $500,000 | $400,000 – $750,000 | $591.90 | $78.60 |
| > $500,000 | > $750,000 | $628.90 | $85.80 |
Looking Ahead
Unless Congress makes changes, IRMAA thresholds are scheduled to once again adjust with inflation starting in 2028. Projections from Medicare Trustees suggest that by 2034, the first IRMAA threshold may rise to $130,000 for individuals ($260,000 for couples), with the highest premiums topping $1,100 per month per person.
Where the 2034 IRMAA Brackets may be:
| 2034 Brackets | |||
| Individual MAGI | Couple MAGI | Part B | Part D |
| < $130,000 | < $260,000 | $347.50 | Premium (varies) |
| $130,000 – $163000 | $260,000 – $326,000 | $486.50 | $38.40 |
| $163,000 – $200,000 | $326,000 – 400,000 | $695.00 | $76.90 |
| $200,000 – $243,000 | $400,000 – $486,000 | $903.50 | $115.30 |
| $243,000 – $574,000 | $486,000 – $860,000 | $1,112.00 | $153.80 |
| > $574,000 | > $860,000 | $1,181.50 | $166.60 |
The Bottom Line
- IRMAA is not going away—and it is growing.
- Income from wages, pensions, investments, and Traditional 401(k) withdrawals all count toward IRMAA.
- Because Medicare premiums are automatically deducted from Social Security, the impact is felt immediately.
Planning matters. By managing taxable income and choosing how you draw from retirement accounts, you may reduce or even avoid falling into higher IRMAA brackets.
Your health is your greatest asset—and so is protecting your retirement income.
Dan McGrath
The Integrity Life Brokerage
📞 617-894-8043 (text preferred)
✉️ dan@theintegritylb.com
