Medicare IRMAA costs in 2021

Medicare Part B premiums will increase by about $4 per month next year and high-income surcharges will also rise modestly in 2021,

The standard Medicare Part B premium, which covers doctor’s visits and other outpatient services, will increase to $148.50 per month in 2021, up $3.90 from this year’s monthly premium of $144.60.

Medicare imposes surcharges on higher-income beneficiaries. The theory is that higher-income beneficiaries can afford to pay more for their healthcare. Instead of doing a 25/75 split with the government, you must pay a higher share of the program costs.

The surcharge is called IRMAA, which stands for Income-Related Monthly Adjustment Amount.

The income used to determine IRMAA is your AGI plus municipal bond interest from two years ago. Your 2019 income determines your IRMAA in 2021. Your 2020 income will determine your IRMAA in 2022 and so on.

As if it’s not complicated enough for not moving the needle much, IRMAA is divided into five income brackets. Depending on your income, higher-income beneficiaries pay 35%, 50%, 65%, 80%, or 85% of the program costs instead of 25%.

The lines drawn for each bracket can cause a sudden jump in the premiums you pay. If your income crosses over to the next bracket by $1, all of a sudden your Medicare premiums can jump by over $1,000/year. If you are married and both of you are on Medicare, $1 more in income can make the Medicare premiums jump by over $1,000/year for each of you.

So if your income is near a bracket cutoff, see if you can manage to keep it down and make it stay in a lower bracket. Using the income from two years ago makes a little harder. Now in 2020, you don’t know where exactly the brackets will be for 2022. Still, you can make reasonable estimates and give yourself some margin to stay clear of the cutoff points.

IRMAA Brackets

The IRMAA income brackets (except the very last one) started adjusting for inflation in 2020. Below are the IRMAA income brackets for 2020 coverage and the new brackets for 2021 coverage.

Before the government publishes the official numbers, I’m able to make projections based on the inflation numbers to date. Rounding rules make it such that the inflation numbers for the upcoming months are unlikely to affect the final results. For example, when a number is rounded to the nearest $1,000, it doesn’t matter whether the number is really $87,600 or $87,800 before rounding. Remember the income on your 2019 tax return (AGI plus muni interest) determines the IRMAA you pay in 2021. The income on your 2020 tax return (to be filed in 2021) determines the IRMAA you pay in 2022.

2021 Parts B and D Income-Related Premiums

Beneficiaries who file an individual tax return with income:Beneficiaries who file a joint tax return with income:Beneficiaries who are married, but file a separate tax return with income:2021
Total monthly Part B premium amount 
Part D income-related monthly adjusted amount paid to Medicare (in addition to plan premiums)
Less than or equal to $88,000Less than or equal to $176,000Less than or equal to $88,000$148.50your plan premium
Greater than $88,000 and less than or equal to $111,000Greater than $176,000 and less than or equal to $222,000 $207.90$12.30 + your plan premium
Greater than $111,000 and less than or equal to $138,000Greater than $222,000 and less than or equal to $276,000 $297.00$31.80 + your plan premium
Greater than $138,000 and less than or equal to $165,000Greater than $276,000 and less than or equal to $330,000 $386.10$51.20 + your plan premium
Greater than $165,000 and less than $500,000Greater than $330,000 and less than $750,000Greater than $88,000 and less than $412,000$475.20$70.70 + your plan premium
Greater than or equal to $500,000Greater than or equal to $750,000Greater than or equal to $412,000$504.90$77.10 + your plan premium

Higher-income Medicare beneficiaries also pay a surcharge for Part D. The income brackets are the same. The surcharges are relatively smaller in dollars.

It’s too early to project the income brackets for 2022 coverage. Right now we only have one data point out of 12 to calculate the brackets for 2022. We’ll have three data points out of 12 by mid-December. If I must guess, the range for the first tier will be between $88,000/$176,000 (no change from 2021) and $90,000/$180,000, with the most likely scenario in the middle, i.e. $89,000/$178,000.

The standard Medicare Part B premium is $148.50/month in 2021. A 40% surcharge on the Medicare Part B premium is about $700/year per person or about $1,400/year for a married couple both on Medicare. In the grand scheme, when a couple on Medicare have over $174k in income, they are probably already paying a large amount in taxes. Does making them pay another $1,400/year make that much difference? Nickel-and-diming just annoys people. People caught by surprise when their income crosses over to a higher bracket by just a small amount get mad at the government. Rolling it all into the income tax would be much more effective.

Oh well, if you are on Medicare, watch your income and don’t accidentally cross a line for IRMAA.


If your income two years ago was higher because you were working at that time and now your income is significantly lower because you retired (“work reduction” or “work stoppage”), you can appeal the IRMAA assessment. The “life-changing events” that make you eligible for an appeal include:

  • Death of spouse
  • Marriage
  • Divorce or annulment
  • Work reduction
  • Work stoppage
  • Loss of income from income producing property
  • Loss or reduction of certain kinds of pension income

You file an appeal by filling out form SSA-44 to show that although your income was higher two years ago, you had a reduction in income now due to one of the life-changing events above.

For more information on the appeal, see Medicare Part B Premium Appeals.

You will not be penalized for life

If your income two years ago was higher and you don’t have a life-changing event that makes you qualify for an appeal, you will pay the higher Medicare premiums for one year. IRMAA is re-evaluated every year as your income changes.

If your higher income two years ago was due to a one-time event, such as realizing capital gains or taking a large withdrawal from your IRA, when your income comes down in the following year, your IRMAA will also come down. The change will take plans every year in January.

If you have any questions about this or anything related to Medicare, give me a call. I help people every day understand the complexities of Medicare. I’m happy to help.

Todd Reagin Maine Medicare Insurance Agent Local Agent help with costs Medicare Advantage Medicare supplement costs compare prices in Maine

Todd Reagin

If you would like help understanding your costs or need help finding a plan or if just want to ask a few questions, you can call 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.