Let’s walk through what IRMA is, who it affects, and how you can keep more of your retirement income in your pocket.

What Is IRMA and Why Does It Matter?

In 2025, the standard Medicare Part B premium is $185 per month. But if your modified adjusted gross income (MAGI) from two years ago was above a certain threshold, IRMA kicks in—and it can push your premium as high as $628.90/month.

That means a high-earning retiree couple could end up paying $10,000 or more per year for Medicare Part B alone.

IRMA is calculated using lines 11 and 2A from your tax return (MAGI = Adjusted Gross Income + Tax-Exempt Interest), and the Social Security Administration (SSA) reassesses this each year using your tax return from two years prior.

2025 IRMA Brackets at a Glance

Here’s a snapshot of what you could pay based on your income:

• Single filers
  • $106,000–$133,000: $259/month
  • $133,000–$166,000: $381/month
  • $166,000–$499,999: $508.90/month
  • $500,000+: $628.90/month
• Married filing jointly
  • $212,000–$266,000: $259/month
  • $266,000–$332,000: $381/month
  • $332,000–$749,999: $508.90/month
  • $750,000+: $628.90/month

As I like to say—IRMA is a first-world problem, but it’s a real one. And it can be triggered by things you might not expect.

What Can Trigger IRMA?

Even if you’re not earning a high salary in retirement, some one-time financial events can push you into a higher IRMA bracket:

• Selling a home – Capital gains can boost your MAGI unless you qualify for the home sale exclusion ($250K for singles, $500K for couples).
• Roth IRA conversions – Large conversions in a single year raise your MAGI significantly.
• Severance pay or pension lump sums – These big payouts count toward your income the year you receive them.
• Stock dividends or options – High capital gains or dividends from investments also raise MAGI.

3 Ways to Minimize or Avoid IRMA

Luckily, with proper planning, there are several strategies that can help reduce your exposure to IRMA:

1. Time Financial Moves Carefully
If you’re planning a Roth conversion, home sale, or big withdrawal, consider doing it before enrolling in Medicare. That way, the spike in income won’t affect your future premiums.

2. Use Tax-Advantaged Accounts
Keep contributing to your HSA or FSA while you’re still working. These reduce your MAGI. Just remember—you can’t contribute to an HSA once you’re on Medicare Part A, so plan accordingly.

3. Split Severance Pay
If you’re offered a large severance, ask if it can be spread out over two or more years. This helps avoid an income spike that triggers IRMA.

What If You’re Already Hit With IRMA? Appeal It.

If your income has gone down significantly due to a life-changing event like:

• Retirement
• Marriage or divorce
• Death of a spouse
• Reduction in work hours
• Loss of pension or property

…you can file an appeal using Form SSA-44 with the Social Security Administration.

You’ll need to provide documentation (like a retirement letter or death certificate), but if approved, your Medicare premiums could drop by hundreds per month.

We’re Here to Help

At Medicare School, we’ve helped thousands of people navigate tricky IRMA situations. Whether you need help filing an appeal, understanding your income thresholds, or building a tax strategy before enrolling, we’re just a call away.

Don’t let IRMA catch you off guard. A little planning today can save you thousands tomorrow.

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