Correcting a Common Misconception About IRMAA

John Robinson |

By John H. Robinson, Financial Planner (Feb 27, 2024)

The “income-related monthly adjustment amount” (IRMAA) is the fee that American consumers must pay in addition to their regular premium cost of Medicare Part B ($174.40 per month for 2024) and Part D if their incomes are above the thresholds listed below:

Because the Medicare IRMAA is based on the income reported in the past two years, many consumers errantly believe they need to keep their income low in the two prior years to applying for Medicare at age 65 to avoid the surcharge.  This is problematic because the two years before age 65 (as well as the subsequent two years before Social Security FRA) are often prime years for Roth conversions, which temporarily inflate taxable income.

Fortunately, the Social Security Administration has a sympathetic ear and is understanding of how taxpayer’s wage income may cause modified adjusted gross income (MAGI) to exceed the Medicare surcharge threshold before retirement.  Form SSA-44 enables taxpayers to request a lowering or elimination of IRMAA due to a life-changing event, such as retirement.  It is important to note, however, that while SSA considers the loss of earned income due to retirement to be a life-changing event, it does not consider Roth conversions in the same light.  Thus, in requesting an IRMAA adjustment it is important to exclusively focus on the impact that earned income had on exceeding the income thresholds presented in the table above.

Related Reading:

Medicare Premiums After Roth Conversion (Ed Slott & Company)

Request to Lower and Income-Related Monthly Adjustment Amount (

Social Security Form SSA-44:  How to fill it out and submit it. (Smart Asset)

Seven Ways You Can Avoid Higher Medicare Premiums (AARP)