Two couples retired within weeks of each other in early 2025, ending high-paying careers that had pushed their 2024 income above Medicare’s IRMAA thresholds. When their 2026 Medicare bills arrived, one couple paid the standard Part B premium of $202.90 per person. The other paid $284.10 per person, plus a Part D surcharge. The difference was not their retirement date or their 2024 income. It was that one couple filed Form SSA-44, telling Social Security that retirement, a qualifying life-changing event known as work stoppage, had reduced their income and asking Medicare to base their premiums on that lower amount.
The Income-Related Monthly Adjustment Amount, or IRMAA, affects roughly 8% of Medicare Part B beneficiaries. If your household income sits comfortably below the 2026 thresholds of $218,000 for joint filers or $109,000 for single filers, this article likely does not apply to you. But if you retired after a high-earning final work year or had a one-time income spike in 2024, such as from selling a business or taking a large required minimum distribution, you could be paying a surcharge based on income you no longer receive.
The Two-Year Lookback That Locks In Your 2026 Premium
Social Security generally sets your 2026 Medicare IRMAA using your 2024 tax return. Your income from two years ago usually drives the bill you pay today. For IRMAA, MAGI means adjusted gross income on Form 1040 line 11, plus tax-exempt interest on line 2a. Municipal bond income that feels tax-free still counts, which is where many retirees near a bracket edge get surprised.
Here are the 2026 Part B tiers for joint filers, per person:
| 2024 Joint MAGI | Monthly Part B (per person) | Part D IRMAA add-on |
|---|---|---|
| Up to $218,000 | $202.90 | $0.00 |
| $218,001 to $274,000 | $284.10 | $14.50 |
| $274,001 to $342,000 | $405.80 | $37.50 |
| $342,001 to $410,000 | $527.50 | $60.40 |
| $410,001 to under $750,000 | $649.20 | $83.30 |
| $750,000 and above | $689.90 | $91.00 |
At the first joint tier, the surcharge alone costs a couple $1,948.80 more in Part B than the standard premium, plus $348 in combined Part D IRMAA. That is $2,296.80 for the year, from income the couple may no longer earn.
The Form That Rewrites the Lookback
Form SSA-44 lets Social Security use a more recent, lower income year instead of the 2024 return, but only when a specific life-changing event caused the drop. The form recognizes eight triggers: marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, certain losses of income-producing property, loss of pension income, and an employer settlement payment.
Retirement can qualify as work stoppage. That is what separated the two couples. Each spouse in Couple A contacted SSA in January 2026 with a retirement letter, projected 2026 income under $218,000, and a signed attestation. Their premiums could be reduced to $202.90. Couple B assumed the higher bill was permanent and paid it.
Read the eligibility list carefully. A Roth conversion, voluntary home sale, large capital gain, or inherited IRA distribution generally falls outside the eight categories. SSA-44 will not undo a voluntary income event by itself, no matter how much it raised MAGI. That is one of the most common misuses of the form.
The Survivor Trap Almost No One Sees Coming
When one spouse dies, the survivor may eventually file as single. The single IRMAA brackets are roughly half the joint brackets. A widow or widower with portfolio income that kept a couple under $218,000 can find that income over the $109,000 single threshold. The bracket shifted, even if the portfolio did not.
Death of a spouse is a qualifying life-changing event for SSA-44. The survivor can request a new IRMAA determination if the death reduces MAGI or changes filing status in a way that lowers the surcharge. SSA may use an estimate or a more recent tax year, depending on the timing and facts.
What To Do
- If you retired, reduced hours, or lost pension income in 2025 or 2026 and your 2024 return would otherwise push you into an IRMAA tier, request a new determination using SSA-44. Attach proof of the event and a good-faith estimate of the current year’s MAGI.
- If your spouse died and your income or filing status now supports a lower surcharge, request an IRMAA recalculation rather than waiting for the two-year lookback to catch up. SSA may already have proof of death, but be prepared to provide documentation if needed.
- If your income sits within $20,000 of a bracket and the trigger is a planned Roth conversion or asset sale, model the conversion against the resulting IRMAA surcharge before you execute. SSA-44 generally will not reverse a voluntary income spike after the fact.
Do Not Pay the Lookback Without Checking the Exception
A high 2024 income year can follow a retiree into 2026 Medicare premiums, but SSA-44 is the built-in exception for people whose income fell because of a qualifying life event. The key is knowing the difference between a voluntary income spike and a real change in work, pension, marital, or survivor status. One is usually stuck in the lookback. The other may justify a lower bill.
Figures reflect the 2026 Medicare plan year, drawn from the CMS fact sheet released November 14, 2025.
Contact [email protected] for any questions or corrections.
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