I’ve been a CPA since 1981. I spent a decade on Wall Street. I’ve written about money for more than 35 years. And last year, Medicare still managed to overcharge me by thousands of dollars.
Here’s the kicker: It wasn’t a mistake. The system was working exactly as designed.
The good news? I found the fix. One form is getting me back nearly $7,000. And I’m going to walk you through it, step by step.
Why Medicare charges high earners more
Most folks pay the standard Medicare Part B premium, which is $202.90 a month in 2026. But if your income tops a certain level, the government tacks on a surcharge called IRMAA — the income-related monthly adjustment amount.
It hits Part B and Part D both. And it stings. At the top brackets, your Part B premium alone can run close to $690 a month, according to the Centers for Medicare & Medicaid Services. There’s a whole list of income types that can push you over the edge.
The two-year trap nobody warns you about
Here’s the part that blindsides people. Your 2026 premiums aren’t based on your 2026 income. They’re based on your tax return from two years earlier — in my case, 2024.
So one good year can haunt you two years later, even if your income has since fallen off a cliff. That’s exactly what happened to me.
My income in 2024 was high. High enough to max out my premiums. Then last year I dialed my hours way back, and my income dropped hard.
But Medicare didn’t care. It was still charging me based on that big 2024 number.
The brackets are cliffs, too. Go one dollar over a threshold and you eat the whole surcharge — not a little more, the entire thing.
1. I confirmed I was actually being penalized
First, read your IRMAA determination letter from Social Security. It spells out what you’re paying and why. Mine showed I was stuck at the top surcharge, all because of one strong year.
2. I figured out whether I had a qualifying event
This is where most people trip. A lower income by itself won’t get you relief. Your drop has to trace back to one of eight specific life-changing events the government recognizes.
Retiring, losing a job, a spouse’s death, divorce, a lost pension — and the one that applied to me, cutting my work hours. That last one’s officially called a work reduction. You have to include a formal statement describing the life-changing event. If you cut down your hours, like I did, you’ll need a statement from your employer and/or W-2 forms to prove you worked less.
Since I own my own business and thus don’t have an outside employer, I just wrote a sworn statement.
Miss this step and you’ll file a form that goes nowhere. If you’re just trying to keep your premiums down in general, that’s a different playbook.
Quick gut-check — if your money advice is coming from random online influencers, you’re playing a dangerous game. I’ve been a CPA since 1981 and writing about money since before the internet existed. Sign up for the free Money Talks Newsletter and get expert advice that’s been tested by time.
3. I filled out Form SSA-44
The form is titled Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event, and it’s free at SSA.gov. You check your event, then estimate your income for the lower year. In my case, this part was easy: I just used the income from my 2025 1040 tax return; I didn’t have to estimate it.
By the way, even after more than four decades as a CPA, I didn’t do this solo. I used AI to pressure-test which event applied to me, draft a clean income estimate, and make sure I wasn’t forgetting any evidence that needed to be included with my SSA-44.
It turned a dreaded afternoon of government paperwork into less than an hour of actual work.
4. I gathered my proof
The Social Security Administration wants evidence, not just your word. That means a statement about your reduced work, a retirement or severance letter, or a clear write-up of your new income.
Be specific. “I cut my hours and my income fell to X” beats a vague sentence every single time. The more concrete your paperwork, the faster this goes.
5. I’ll submit it in person, then wait for the refund
You can file online, by fax, by mail, or in person. Doing it in person is often fastest, because a rep can review your documents on the spot and sometimes decide right there. I just put my package together yesterday and plan to drop it off at a local office next week. It’s probably going to take a few months to get through the system.
Even though I’m just filing for a refund now, if approved, my refund will be retroactive to the first of January of 2026, which should add up to close to $7,000.
If you think you were overcharged in a past year, it’s worth checking whether you’re owed money for that too.
The bottom line
The system counts on you not knowing this form exists. Most people never file it. They just swallow the surcharge and move on, thousands of dollars poorer.
Don’t be most people. If your income dropped because you retired, cut your hours, lost a spouse, or had another qualifying event, find out whether you’re owed a refund.
The form takes about 45 minutes, including creating your statement (AI helped with mine) and gathering the required information, like tax returns. Is it a bit of a pain? Sure. But is a 45-minute hassle worth seven grand? You bet.
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