IRMAA Appeal Checker: the facts

1. Medicare premiums for 2026 are set from the 2024 tax return; the first surcharge begins above $109,000 single and $218,000 joint, and the top tier adds $578.00 a month per person.
2. If income has fallen since that year because of a major life-changing event, Social Security will set the surcharge from a more recent year instead (20 CFR 418.1201). The events are seven: a spouse's death, marriage, divorce or annulment, stopping or reducing work, loss of income-producing property, loss of pension income, and an employer settlement (418.1205).
3. Retirement is the common one: stopping work counts, and the request can be made as soon as the retirement is certain, using the expected income for the year.
4. What does not count: selling property or a business by choice, ordinary investment losses, and a one-time spike such as a Roth conversion, a large IRA withdrawal, or a capital gain in the lookback year (418.1210). Those are paid for one year and roll off.
5. Example: someone who retired after a $250,000 year and expects $90,000: tier 4 on the old return, tier 0 on the new income, $6,355 a year saved by filing the form.
6. The request is Form SSA-44, with evidence of the event and of the new income; it is made once, and Social Security uses the new year for the premium year in question. Each spouse on Medicare files their own.

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