What income sources count toward IRMAA for Medicare Part B and D in 2025?
Executive summary
IRMAA for 2025 is charged on Medicare Part B and Part D based on your Modified Adjusted Gross Income (MAGI) from your 2023 tax return; thresholds begin at $106,000 for single filers and $212,000 for joint filers and rise through a series of higher brackets (affecting millions of beneficiaries) [1] [2]. The Social Security Administration applies a two‑year lookback, adds certain tax‑exempt interest back into AGI to form MAGI, and lets you appeal or request a redetermination if a life‑changing event lowered your income [1] [3].
1. What “income” IRMAA actually uses — the MAGI the government looks at
For IRMAA the SSA uses your Modified Adjusted Gross Income (MAGI): that is your federal Adjusted Gross Income plus specific tax‑exempt interest (line 2a on Form 1040), and the SSA pulls the MAGI and filing status from your tax return two years earlier to set premiums for Parts B and D [1] [4]. Multiple consumer guides repeat the same rule: your 2025 IRMAA is based on your 2023 MAGI [5] [6].
2. Which specific income items typically count toward MAGI (and thus IRMAA)
Sources explicitly state that AGI is the starting point and that the SSA adds tax‑exempt interest and some items not included in AGI for their MAGI calculation; examples called out by reporting include tax‑exempt municipal bond interest and interest from U.S. savings bonds used for education — those must be added back to AGI when SSA computes MAGI for IRMAA [1] [7]. Consumer planning pieces and advisers emphasize that traditional taxable income types (wages, RMDs from IRAs, taxable pensions, capital gains) flow into AGI and therefore into MAGI and IRMAA [8] [9].
3. What common items people ask about are NOT directly listed in these sources
Available sources do not mention a comprehensive, line‑by‑line IRS list in this packet (for example, which specific exclusions or foreign income exceptions are or aren’t added back beyond the tax‑exempt interest examples). For any ambiguous items you should consult the actual SSA/IRS guidance cited by Social Security or seek tax counsel — the provided materials point to AGI plus tax‑exempt interest as the operative definition but do not enumerate every special case [1].
4. Timing and administrative mechanics that matter to planning
The IRMAA decision uses your tax filing status and MAGI from two years prior; therefore, actions you take in 2025 (or income changes in 2025) don’t affect your 2025 IRMAA — they will show up two years later. If you believe your IRMAA is wrong because of a life‑changing event (retirement, divorce, death of spouse, etc.), SSA accepts a Form SSA‑44 to request use of a more recent tax year or to seek redetermination; SSA also mails predetermination notices when it receives IRS data [1] [10].
5. Who pays and how much — the practical stakes
For 2025 the first IRMAA threshold begins at $106,000 individual / $212,000 joint MAGI; beneficiaries above those amounts pay surtaxes on top of the standard Part B and Part D premiums, with a sliding scale of higher brackets that substantially increase monthly costs [2] [10]. Reporting notes that millions of beneficiaries face IRMAA surcharges (roughly millions paid IRMAA for Part B and Part D across recent years), making MAGI‑sensitive planning a meaningful cost control issue [3].
6. How advisers and outlets frame mitigation strategies (and their implicit agenda)
Wealth advisers and financial publishers repeatedly suggest strategies — e.g., increasing tax‑deferred retirement contributions while still working, timing Roth conversions, qualified charitable distributions, and managing RMD timing — because those moves can lower MAGI in a given tax year and thus reduce future IRMAA exposure [8] [9]. These sources have an implicit agenda: to promote tax‑efficiency tactics that preserve wealth and generate business for advisors; readers should treat these suggestions as planning options to discuss with a tax professional [9].
7. Bottom line and recommended next steps
To know if you owe IRMAA in 2025, check your 2023 tax return’s AGI, add any tax‑exempt interest to form MAGI as SSA does, and compare to the published thresholds (start at $106,000/$212,000) [1] [2]. If your income has fallen since 2023 because of a qualifying life‑changing event, file SSA‑44 with supporting documents to seek redetermination; for complex cases consult a tax advisor or SSA directly because the summaries here do not list every special income treatment [1] [10].