If your income is above a certain level, Medicare adds a surcharge to your Part B and drug premiums. It’s called IRMAA — the Income-Related Monthly Adjustment Amount — and it’s set from your tax return from two years ago.
This affects roughly 8% of people on Medicare, so it may well not be you. But if you’re a higher earner it’s worth knowing ahead of time, because the return Medicare looks at is from back when you were still working. The lag doesn’t clear in a year, either — it’s recalculated annually, always two years behind, so a retiree can see the surcharge for a couple of years running on income they no longer have.
CMS publishes the current income brackets and amounts here:
2026 Medicare Parts A & B Premiums and Deductibles
The fix is Form SSA-44, Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event. Retirement counts as a life-changing event. You file it, you show what you actually make now, and Social Security prices you on that instead of waiting for the lookback to catch up.
It works. It just doesn’t happen automatically, and nobody mails you a reminder — so if your income changed, appeal.