Key Takeaways

• IRMAA surcharges for Medicare Part B and Part D can significantly raise your clients’ premiums, especially if they don’t anticipate the income-based thresholds.

• Your ability to explain IRMAA in plain terms—before the bill hits—builds credibility, retains clients, and helps avoid frustration down the road.

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Start With the Basic Definition—Then Stop

When introducing IRMAA (Income-Related Monthly Adjustment Amount), it’s tempting to dive into the federal acronyms, MAGI formulas, and income brackets right away. Don’t. Start simply:

“IRMAA is an extra charge added to Medicare premiums for people with higher incomes.”

This is enough to ground the conversation. Once your client understands that IRMAA is an additional cost tied to their income, you can gradually walk them through the details—only as much as they need to make an informed decision.

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Explain Where IRMAA Comes From

Help clients understand that IRMAA isn’t an insurance company fee—it’s a federal surcharge determined by law.

• The Social Security Administration (SSA) uses tax information to determine IRMAA.

• Specifically, it looks at your client’s Modified Adjusted Gross Income (MAGI) from two years ago. In 2025, that means income from 2023.

• If their MAGI is above a certain threshold, they pay more for Part B and Part D coverage.

This isn’t negotiable. And it isn’t about their assets—it’s about reportable income.

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Clarify the Income Brackets Without Overwhelming

As of 2025, IRMAA begins when an individual’s MAGI exceeds $106,000 or when a couple filing jointly exceeds $212,000. From there, surcharges increase in five income tiers.

Rather than reciting each bracket:

• Use a visual chart or calculator (in a client meeting or marketing material).

• Summarize the logic: “The more income you report, the higher the surcharge. It’s tiered, not all-or-nothing.”

Clients don’t need to memorize numbers. They need to know if their income might trigger a surcharge and what that could mean.

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Show the Real Impact on Medicare Part B and D Costs

In 2025, the standard monthly premium for Medicare Part B is $185. But with IRMAA, this amount rises significantly—often by hundreds per month.

• The highest tier pushes the Part B premium to well over $500 monthly.

• Part D also sees tiered IRMAA surcharges added to any base plan premium.

Again, avoid discussing specific plans or private provider costs. Instead, emphasize that IRMAA adds a fixed dollar amount based on income, regardless of the base plan your client chooses.

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Help Clients Understand How They Could Accidentally Trigger IRMAA

Many clients don’t realize how easy it is to cross an IRMAA threshold:

• One-time events like Roth conversions or capital gains can inflate MAGI.

• Taking required minimum distributions (RMDs) from retirement accounts in large sums.

• Selling a home or business.

What matters is the reported income for the year—intent doesn’t count. Even if it’s a one-time bump, IRMAA gets applied for the full calendar year.

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Reassure Them: There Are Ways to Plan Around It

IRMAA can’t always be avoided, but with foresight, it can be reduced or managed.

Offer strategies like:

• Spreading income over multiple years instead of taking large distributions all at once.

• Timing Roth conversions before or after retirement to avoid high-income years.

• Managing capital gains, especially in taxable investment accounts.

While tax planning should be handled by a CPA, your role is to prompt the conversation. Clients appreciate agents who don’t just react—they prepare.

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Highlight the Life-Changing Events That Can Reduce IRMAA

If a client’s income has dropped significantly since the year used to assess IRMAA (typically two years prior), they can request a reconsideration from the SSA.

Qualifying life-changing events include:

• Retirement

• Marriage or divorce

• Death of a spouse

• Loss of income-producing property

• Loss of pension or income

• Work reduction

Encourage clients to submit SSA Form SSA-44 along with supporting documentation. You don’t need to fill it out for them—but you should let them know it exists.

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Don’t Skip Over Part D IRMAA

While clients often focus on Part B premiums, IRMAA also applies to Medicare Part D.

The surcharge:

• Is added to whatever Part D plan premium the client has.

• Must be paid directly to Medicare—not the plan provider.

• Continues for the full year once applied, even if the client changes their plan.

This is one of the most misunderstood parts of IRMAA. Clients often think the surcharge disappears when they switch drug plans. It doesn’t.

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Explain How IRMAA Affects the Whole Year

Once IRMAA is assessed for a year, it sticks—monthly. Even if your client enrolls mid-year or only needs temporary coverage, they’ll pay the surcharge each month.

This can frustrate clients who:

• Delay Medicare until age 67 and assume they’ll avoid past income impact.

• Enroll late and don’t expect a higher premium because “this isn’t my full income year.”

Set the expectation that IRMAA is based on prior returns, not current need or usage.

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Anticipate the “Unfair” Reaction—and Keep Them Focused

Some clients will push back: “I paid into Medicare all my life, why am I being penalized now for having income?”

It’s important to separate empathy from reinforcement:

• Acknowledge their frustration: “It does feel unfair when it’s unexpected.”

• Clarify that this is not a penalty but a progressive cost structure based on income.

• Reinforce that it’s reviewable if their financial situation changes.

The tone you take here matters more than the explanation. Calm delivery and proactive planning shift the conversation from frustration to action.

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Keep the Bigger Picture in View

You’re not just there to explain costs—you’re there to help clients find value. Many high-income retirees still benefit from the structure Medicare offers, even with IRMAA surcharges.

Focus on the total benefit package:

• Comprehensive coverage compared to private alternatives

• Predictability in healthcare access and costs

• Ability to tailor coverage with Medigap or Advantage options

When clients see IRMAA as one piece of a larger puzzle, they’re less likely to fixate on the surcharge itself.

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The Power of a Forecasting Conversation

Before your client turns 63, you should already be talking about IRMAA. That’s the income year used to calculate their premiums at 65.

Forecasting lets you:

• Catch potential IRMAA triggers before they hit.

• Collaborate with tax professionals to develop a two-year plan.

• Set realistic expectations about what Medicare will cost.

Too often, IRMAA gets explained only after the letter arrives. That’s too late. The power of an agent lies in helping clients look forward, not just back.

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IRMAA Education Creates Stronger, Smarter Client Relationships

IRMAA isn’t just about explaining a surcharge. It’s about proving you’re a partner in the client’s financial wellness. The agents who demystify Medicare’s costs—especially the unexpected ones—stand out.

By offering:

• Proactive education

• Clear, relatable language

• Insight into planning opportunities

You’re not just answering questions. You’re becoming the go-to source for clarity, trust, and long-term value.

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Want to Lead the Medicare Conversation with Confidence?

Helping clients understand IRMAA is a chance to prove your value—not just as a Medicare expert, but as a strategic partner in retirement planning.

That’s exactly what we support at BedrockMD. We offer:

• Resources to explain IRMAA clearly and compliantly

• Automated tools to predict IRMAA exposure

• Lead generation systems built around real Medicare concerns

Sign up today at BedrockMD and let us help you become the agent your clients count on before, during, and after enrollment.