Meet Medicare’s ‘girlfriends’ MAGI and IRMAA

on Apr 3, 2025

I enrolled in a $0 premium Medicare Advantage plan to begin April 1st when I turn 65. I chose to disenroll from my husband's employer benefits because my monthly premium is $0, making it more cost-effective for us.

Now I am in shock because a Medicare premium of $670.50 was deducted from my Social Security check. I was told by the agent who enrolled me in the Advantage plan that my premium would be $0.

My husband John is 63 and wants to continue working until he is 70. He is a vice president of a local bank and has a nice salary. I may have made a mistake by enrolling in this Medicare Advantage plan and leaving his employer plan. I cannot return to his plan until January of next year. Can you please explain what I did wrong?

–Susan from Atlanta

Hello Susan:

You have been introduced to Medicare’s girlfriends: MAGI (Modified Adjusted Gross Income) which explains what your yearly income bracket is and IRMAA (Income Related Monthly Adjusted Amount) which shows what your monthly premium will be.

Besides the two girlfriends, Medicare also has two family members: the IRS and Social Security. The IRS informs Social Security that both yours and John’s income from your last filed tax return was between $400,000-$750,000 and Social Security deducts the $670.50 from your monthly Social Security check for your Medicare premium. Susan, the premium for your Medicare Advantage plan is still $0. That has not changed.

In 2025, if your yearly tax return income filed as an individual was $106,000 or less or filing a joint tax return was $212,000 or less, then Medicare Part B premium would be $185 monthly, without additional IRMAA added. Those, like you, whose income is higher than $106,000 as an individual or $212,000 as a couple, will pay a higher amount with the additional IRMAA added to your monthly premium. Social Security explains in the letter that was mailed to you how they arrived at the Part B and D premiums based on your MAGI from your last filed tax return and that you will have the additional IRMAA premium added.

The IRMAA rule for Medicare went into effect regarding additional IRMAA premiums on January 1, 2011, and new Medicare Part B and D premiums for the different income brackets began being released every fall to begin January 1.

Medicare confusion begins when one approaches 65 and is bombarded by call centers and mountains of direct mail advertising. America needs to realize that the person on the other side of the call is only looking to make a sale and not always providing proper information.

Susan, had you contacted the Toni Says Medicare team, we would have advised you not to enroll in Medicare Part B, since you were covered with your husband’s employer benefits, but to enroll in Part B when John decides to retire. When John retires at 70, there will be a different process for enrolling in Medicare. (Chapter 1 of my Medicare Survival Guide Advanced edition explains the different ways to enroll in Medicare properly, based on one’s circumstances.)

When John finally retires, he will have a special situation known as a “Life-Changing Event” which can lower your IRMAA premium. A few of the life-changing events that can make your MAGI go down are:

-- Married, divorced or your spouse has died

-- You or your spouse have stopped working or reduced hours

-- Loss of income producing property

-- Loss of pension income

Use form SSA-44 (Medicare IRMAA-Life-changing event form) to advise Social Security of your change in income. Visit SSA.gov or email info@tonisays.com for a copy of the form.

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Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. The “Medicare Survival Guide Advanced” edition and her new “Confused about Medicare” video series are available at www.tonisays.com.