08/19/2026
Many retirees assume Medicare premiums are fixed, but they're not.
In fact, premiums can be double or more than the base rate.
Here’s the catch: Medicare calculates premiums using your income from two years ago.
So, if you retire this year and your income drops, Medicare still bases your premiums on your higher income from before retirement.
Instead of the standard Part B premium of $202.90 per month, you could be paying $405.80 or more each month. This extra charge is called IRMAA (Income-Related Monthly Adjustment Amount).
For a married couple, that could mean over $4,800 in extra premiums annually.
A common question is: "How can my premiums be this high if I’m retired now?"
The good news? Medicare lets you request a “new initial determination” if your income decreased due to a life-changing event like retirement.
This means you can ask Medicare to recalculate your premiums based on your current income, not the past.
Qualifying events include:
• Retirement or work stoppage
• Reduced work hours
• Divorce
• Death of a spouse
• Loss of income-generating property
If your income drops enough, your premiums could go down.
To do this, submit Social Security Form SSA-44 to report your life-changing event and estimate your new income.
Two important points to remember:
1️⃣ Medicare won’t notify you about this option. You must request it.
2️⃣ If approved, you may get a refund for premiums you’ve already overpaid.
If your request isn’t approved, don’t worry. Medicare reviews IRMAA every year, so most retirees only pay higher premiums for a couple of years after retiring.
Bottom line: Your Medicare premiums aren’t set in stone, they’re based on past income and can be updated if your situation changes.
If your income has dropped, it’s worth asking Medicare to reassess your premiums.