ATLANTA - The Income-Related Monthly Adjustment Amount (IRMA) is a Medicare surcharge that can significantly increase your healthcare costs in retirement based on income from two years prior.

• IRMA affects both Medicare Part B and Part D premiums, potentially adding over $500 per month per person
• The surcharge is based on your Modified Adjusted Gross Income (MAGI) from two years prior
• Income thresholds begin at $106,000 for individuals and $212,000 for joint filers
• One-time income events like selling property or Roth conversions can trigger IRMA
• Higher premiums due to IRMA do not provide better coverage - everyone gets the same benefits
• You can appeal IRMA if you experience life-changing events like retirement or divorce using Form SSA-44
• Strategic planning between ages 59½ and 64 may be critical for minimizing IRMA in retirement
• Qualified Charitable Distributions (QCDs) and donating appreciated assets directly to charity can reduce MAGI
• Tax laws affecting IRMA change regularly, requiring ongoing review of your retirement strategy