A local guide for Medicare beneficiaries in Pensacola, Pace, Gulf Breeze, and Milton
If you have ever opened a letter from Social Security and seen a Medicare premium that is hundreds of dollars higher than you expected, you may have just met IRMAA. IRMAA stands for the Income-Related Monthly Adjustment Amount, and it is one of the most misunderstood parts of Medicare. It catches a lot of people in Escambia and Santa Rosa counties by surprise, especially folks who just sold a home, took a large retirement account withdrawal, or had one good year of income right before turning 65.
As a licensed independent Medicare broker and the owner of AJ Health and Wealth, I help people across Pensacola, Pace, Gulf Breeze, and Milton understand exactly what they are paying for and why. IRMAA questions come up often enough that I wanted to put together a clear, plain-language explanation: what it is, whether you can avoid it, whether you can appeal it, and which parts of Medicare it actually touches.
What Exactly Is IRMAA?
Most people pay a standard premium for Medicare Part B, which in 2026 is $202.90 per month. IRMAA is an extra amount added on top of that standard premium for people whose income is above a certain level. It is not a penalty for doing something wrong. It is simply the government’s way of asking higher-income beneficiaries to cover a larger share of the program’s cost.
The Social Security Administration determines whether you owe IRMAA by looking at your Modified Adjusted Gross Income, or MAGI, from your tax return filed two years earlier. So for 2026 premiums, Social Security is looking back at your 2024 tax return. This two-year lookback is one of the most common sources of confusion. People who retire and see their income drop significantly often still get hit with IRMAA the following year or two, because the calculation has not caught up to their current, lower income yet.
2026 IRMAA Income Thresholds
For 2026, the surcharge kicks in once your MAGI exceeds $109,000 as an individual filer, or $218,000 for a married couple filing jointly. Once you cross that line, IRMAA works on a sliding scale across five tiers, all the way up to $500,000 for an individual or $750,000 for a married couple at the top tier.
Depending on which tier you land in, your total Part B premium in 2026 can range from about $284.10 per month all the way up to $689.90 per month, per person. Part D surcharges are smaller in dollar terms, ranging from roughly $14.50 to $91.00 per month on top of whatever your drug plan already charges.
One important thing to understand is that IRMAA works like a cliff, not a gradual slope. If your MAGI is one dollar over a threshold, you pay the full surcharge for that entire tier, not just on the dollar that pushed you over. That single dollar can cost an individual close to $1,000 extra per year, and married couples where both spouses are on Medicare can see that cost doubled.
Does IRMAA Apply to Part A, Part B, and Part D?
This is one of the questions I get asked most often in my office, so let’s be direct about it:
- Part A: No. Part A is premium-free for most beneficiaries who have worked and paid Medicare taxes long enough, and there is no income-based surcharge on Part A at all, regardless of how much you earn.
- Part B: Yes. This is where most people experience IRMAA directly, since it is added straight onto your monthly Part B premium.
- Part D: Yes. If you have a standalone Part D drug plan, or a Medicare Advantage plan that includes drug coverage, the same income brackets apply, and the Part D surcharge is billed separately, even if your drug plan premium itself is low or zero dollars.
So if you are enrolled in both Part B and a Part D plan and your income is above the threshold, you are paying two separate IRMAA surcharges every month, one tied to Part B and one tied to Part D.
Can You Avoid IRMAA?
There is no way to opt out of IRMAA if your income is genuinely above the threshold in the relevant tax year. It is not optional, and it is not something a broker or agent can waive. What you can do is plan ahead so fewer dollars of income land in the year that counts against you. Some strategies people use, often with the help of a financial advisor or CPA, include:
- Timing large one-time events, like a Roth conversion or the sale of a second property, to avoid stacking too much income into a single tax year.
- Spreading retirement account withdrawals across multiple years instead of taking one large distribution.
- Using qualified charitable distributions from an IRA, which can satisfy required withdrawals without adding to MAGI.
- Working with a tax professional well before you turn 65, since the two-year lookback means decisions made years before Medicare even starts can affect your premiums later.
As a retirement planner as well as a licensed independent Medicare broker, I work with clients in Pensacola, Pace, and Gulf Breeze on this kind of income timing as part of their overall retirement strategy. I am not a CPA or tax preparer, so for the actual tax filing and reporting side, I’ll often coordinate with a client’s accountant to make sure everything lines up.
Can IRMAA Be Appealed?
Yes, and this is the part many people do not realize. While you cannot dispute IRMAA simply because you think it is unfair, you can request a new determination if your circumstances changed, or if the income data Social Security used was wrong or outdated.
Social Security allows appeals based on a life-changing event, using Form SSA-44. Qualifying events include:
- Retirement or reduction in work hours
- Marriage, divorce, or annulment
- Death of a spouse
- Loss of income-producing property, or loss of a pension
If your tax return for the lookback year was amended, or if the SSA used outdated information, you can also contact them directly to request a correction without needing a qualifying life event. You generally have 60 days from the date on your IRMAA notice to file a formal appeal, though Social Security will sometimes consider late requests with good cause. The fastest way to start is by calling Social Security at 800-772-1213.
What This Means for Pensacola, Pace, and Gulf Breeze Retirees
Our area has a lot of retirees who relocated from out of state, sold homes in more expensive markets, or built up substantial savings before settling along the Gulf Coast. That combination, a home sale plus retirement account withdrawals in the same year, is exactly the kind of one-time income spike that can trigger an unexpected IRMAA surcharge two years later.
Whether you are turning 65 in Pace, already on Medicare in Pensacola, or considering a move to Gulf Breeze, the most important thing is to look at your IRMAA exposure before major income decisions happen, not after the surprise notice from Social Security arrives.
Have Questions About IRMAA or Your Medicare Costs?
I’m Mark Garrett with AJ Health and Wealth, and I help Medicare beneficiaries across Pensacola, Pace, Gulf Breeze, and Milton understand exactly what they’re paying for and why — at no cost to you. If you’d like to talk through your specific situation, give me a call.
Mark Garrett — AJ Health and Wealth
Local office: 4279 Woodbine Road, Pace, FL | (850) 316-4378 | ajhealthandwealth.com
AJ Health and Wealth is not connected with the Federal Medicare program. By contacting this number, you will be connected with a licensed insurance agent. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE or your local State Health Insurance Program to get information on all of your options.