Your IRMAA letter from Social Security: what it means
By Elder PaperworkUpdated
Short answer
Social Security sends a letter when you owe higher Medicare premiums. It states the amounts and the reason.
For 2026, the income generally comes from your 2024 tax return, as reported by the IRS.
If a life-changing event lowered your income, you can ask for a new decision.
Sources: Social Security, Medicare premiums; POMS HI 01120.001, June 2026. Read November 4, 2026.
Key facts
What does the IRMAA letter tell me?
It tells you that you owe higher Part B or Part D premiums, how much, and why.
The amounts come from the CMS 2026 table, based on income the IRS reported.
| Single | Joint | Part B total | Part D extra |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Up to $137,000 | Up to $274,000 | $284.10 | $14.50 |
| Up to $171,000 | Up to $342,000 | $405.80 | $37.50 |
| Up to $205,000 | Up to $410,000 | $527.50 | $60.40 |
| Under $500,000 | Under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Which year’s income did Social Security use?
For 2026, generally your 2024 return, filed in 2025. Sometimes your 2023 return.
If you filed a 2024 return, or didn’t have to, tell Social Security so it can update its records.
Is it a final decision?
Not always. A predetermination notice tells you what Social Security plans to do.
It is not a determination and has no appeal rights.
If you disagree with it, you can ask for a new initial determination.
What can I do if the income is too high?
- A life-changing event lowered your income: send Form SSA-44
- You amended your return: send it with the IRS receipt
- The IRS figure is wrong: correct it with the IRS
- You disagree with the decision: ask for a reconsideration
Social Security says you don’t need to appeal for a life-changing event.
Check your case before you send anything.
Check my savingsHow long do I have to act?
An appeal is due within 60 days of receiving the notice. Receipt is presumed 5 days after its date.
A life-changing event request can be made at any time after the event.
Questions
Why did I get an IRMAA letter?
Because the income the IRS reported puts you above the 2026 limit for your filing status.
Do I have to appeal?
Not for a life-changing event. Form SSA-44 asks for a new decision without an appeal.
How long do I have to appeal?
60 days from receiving the notice. Receipt is presumed 5 days after the notice date.