A Complete Guide for Lehigh Valley Medicare Beneficiaries
If your Medicare premium suddenly increased and you’re wondering why, you may be affected by something called IRMAA.
Many retirees in Allentown, Bethlehem, Easton, and throughout the Lehigh Valley are surprised to learn that Medicare premiums are not the same for everyone. If your income was higher in recent years, you may pay more for Medicare Part B and Part D.
Here’s what IRMAA is, how it impacts your Medicare premiums, and how you may be able to appeal it.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount.
It’s an additional charge added to:
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Medicare Part B premiums
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Medicare Part D prescription drug plan premiums
IRMAA applies when your income exceeds certain federal thresholds.
The Social Security Administration determines whether you owe IRMAA based on your Modified Adjusted Gross Income (MAGI) from two years prior.
Example:
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Your 2026 Medicare premiums are based on your 2024 tax return.
How IRMAA Increases Your Medicare Premiums
Most people pay the standard Medicare Part B premium. However, if your income exceeds the threshold, your premium increases in tiers.
Higher income = higher monthly premium.
This adjustment can add hundreds — even thousands — of dollars per year to your Medicare costs.
Important: IRMAA is not permanent, but it does not automatically adjust when your income changes.
What Income Triggers IRMAA?
IRMAA is triggered when your income exceeds federally set limits.
Income includes:
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Wages
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Self-employment income
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Capital gains
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Rental income
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IRA withdrawals
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Required Minimum Distributions (RMDs)
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Certain tax-exempt interest
Even a one-time income spike — such as selling property or a business — can push you into a higher IRMAA bracket.
Many Lehigh Valley retirees encounter IRMAA after:
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Retiring with a pension payout
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Selling a home or investment property
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Converting a traditional IRA to a Roth IRA
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Taking large distributions from retirement accounts
Why IRMAA Often Affects Recent Retirees
Because IRMAA is based on income from two years ago, many people face this situation:
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You were working two years ago and earning a higher salary.
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You are now retired and earning significantly less.
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Medicare still uses your higher income year to calculate premiums.
The result? You may be paying a higher Medicare premium than your current income justifies.
Can You Appeal IRMAA?
Yes — and this is where many beneficiaries miss an opportunity.
If your income has decreased due to a qualifying life event, you may request a reconsideration from the Social Security Administration.
Qualifying Life Events for an IRMAA Appeal
You may qualify for an appeal if your income dropped due to:
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Retirement
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Work reduction
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Marriage
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Divorce
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Death of a spouse
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Loss of pension income
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Employer settlement payment
Retirement is one of the most common and successful reasons for appealing IRMAA.
How to Appeal IRMAA
To request a reconsideration, you must complete:
Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event)
You’ll need to provide:
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Documentation of your life-changing event
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An estimate of your current year income
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Supporting financial records
The Social Security Administration will review your request and determine whether your premiums should be adjusted.
How Long Does an IRMAA Appeal Take?
Processing times vary, but once approved:
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Your Medicare premiums may be reduced
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Overpaid amounts may be refunded
It’s important to act quickly rather than continuing to pay elevated premiums unnecessarily.
Common IRMAA Misunderstandings
Many Lehigh Valley retirees believe:
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“It’s permanent.” (It’s not.)
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“There’s nothing I can do.” (There often is.)
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“Medicare premiums are the same for everyone.” (They are income-based.)
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“Social Security automatically adjusts it when I retire.” (It does not.)
IRMAA requires proactive review.
Planning Ahead to Avoid IRMAA
Strategic retirement planning can help minimize IRMAA exposure.
Strategies may include:
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Managing Roth conversions carefully
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Spreading out large withdrawals
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Timing asset sales strategically
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Coordinating retirement income streams
Because IRMAA is income-based, even small adjustments in planning can make a difference.
Why Local Guidance Matters in the Lehigh Valley
Retirement income planning and Medicare premiums are closely connected.
Working with someone who understands:
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Pennsylvania retirement income rules
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Local retirement demographics
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Medicare enrollment timing
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How IRMAA interacts with retirement planning
can help prevent unnecessary premium increases.
Final Thoughts: Don’t Ignore a Higher Medicare Premium
If your Medicare Part B or Part D premium recently increased, IRMAA may be the reason.
The good news:
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It’s not always permanent.
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It may be appealable.
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It can often be corrected after retirement.
The key is knowing your options.
Need Help Reviewing Your Medicare Premiums?
If you live in the Lehigh Valley and have questions about IRMAA, Medicare costs, or retirement income coordination, a local Medicare review can provide clarity.
At Lehigh Valley Medicare Advisors, we help Pennsylvania retirees understand:
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Why their premiums changed
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Whether an IRMAA appeal makes sense
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How retirement income affects Medicare costs
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What steps to take next
Your retirement budget should be predictable — and Medicare shouldn’t come with surprises.
If you’d like a complimentary Medicare premium review, reach out today.