In my years as a writer and editor for Kiplinger Personal Finance, I frequently advised readers to prepare for substantial out-of-pocket healthcare costs after they retire. Fidelity Investments estimates that a 65-year-old who retired in 2025 will spend an average $172,500 in healthcare and medical expenses in retirement. In a recent column, I discussed my out-of-pocket dental costs, which elicited a lot of interesting feedback from readers who have successfully lowered their dental expenses.
But while I was prepared to pay for expenses that aren’t covered by Medicare, I was taken aback by the cost of Medicare itself — specifically, Medicare Part B, which covers doctor’s visits and other outpatient services. While Part A, which covers hospitalization, is free to most beneficiaries, retirees pay a monthly premium for Part B. I also pay for Part D, which covers prescription drugs.
In 2026, most beneficiaries pay $202.90 a month for Part B. But a small subset of retirees pay a high-income surcharge, also known as the income-related monthly adjustment amount (IRMAA). IRMAA premiums range from $284.10 to $698.90 this year, depending on your modified adjusted gross income, which is your AGI plus adjustments, including tax-exempt interest on your investments. For 2026 premiums, the IRMAA kicks in at a MAGI of more than $109,000 for single filers or $218,000 for those married filing jointly.
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Even though I retired from full-time work early last year, I’m subject to the surcharge because Medicare uses your household income from two years prior to calculate the IRMAA. So the surcharge I’m paying in 2026 is based on what my husband and I earned in 2024, when we were both working full-time. I also pay a high-income surcharge for Part D. While I have self-employment income now, I’m not earning as much as I was two years ago.
Requesting an adjustment
The good news is that you can ask Social Security, which determines Medicare premiums, to reduce or waive the surcharge based on specific life-changing events. Those events include marriage, divorce, death of a spouse and, crucially, retirement. Since I’m no longer working full-time and my husband retired this spring, I plan to request an adjustment in my premiums on Form SSA-44. The form allows you to ask for a redetermination based on an anticipated reduction in income or one that has already occurred. I plan to do the former.
That’s going to require some legwork, because I will have to estimate the amount of income we’ll receive in 2026 from self-employment, required minimum distributions, investments and other sources. I’ll also have to gather some documents, and veterans of this process say more is better. I’ll provide letters confirming that we’ll both be retired for most of 2026, as well as anything else I can find to confirm an expected decline in our income.
Make your case based on an anticipated drop in income or one that has already occurred.
Because I’m basing my appeal on an anticipated drop in income, rather than one that I can prove has already happened, I’m prepared for it to be rejected. But appealing the IRMAA won’t cost anything but my time, so I don’t see any downside to filing the request.
There’s no limit on the number of times you can request a reconsideration, so I can submit a second request after I file our 2026 tax return, which will show how much our income has actually declined. I’m also prepared to make an appointment at a Social Security office — I’ve been told that an in-person visit is sometimes necessary to achieve an IRMAA reconsideration. If my request is approved, Social Security will credit the premiums I overpaid and apply them to future premiums.
I’ll keep you posted on my results. If you’ve successfully appealed a high-income Medicare surcharge, I’d love to hear from you.
Note: This item first appeared in Kiplinger Personal Finance Magazine, a monthly, trustworthy source of advice and guidance. Subscribe to help you make more money and keep more of the money you make here.