This is a situation I see every year.
Someone retires, settles into their new routine, and then a Medicare notice shows up in the mail with a monthly premium that feels completely out of line. Six hundred dollars a month. Sometimes more. The reaction is usually the same.
“How can this be right? I’m retired.”
In most cases, it is technically right. It’s just not current.
Medicare Part B premiums are based on income from two years earlier. That means your 2026 premium is determined using your 2024 tax return, even if your life has changed dramatically since then.
If you retired, reduced hours, or got married, Medicare hasn’t automatically adjusted for that. They are still charging you as if you’re earning what you used to earn.
This income-based adjustment is called IRMAA. It’s not a penalty, but when no one explains it, it can certainly feel like one.
One thing I always remind people is this: paying more for Medicare doesn’t get you anything extra. There’s no special tier of care, no faster access, no “Medicare Black Card” that comes with better treatment. You’re paying more for the exact same coverage as everyone else.
That’s why it’s important to make sure you’re paying the right amount.
Here’s the part many people don’t realize.
When you retire, Medicare allows you to ask for a lower premium. Retirement is considered a life-changing event under Medicare’s rules. Marriage, divorce, and the loss of a spouse also qualify.
What matters is that your current income no longer reflects what appears on that old tax return. Medicare gives you a way to correct that mismatch.
But they won’t do it automatically. You have to tell them.
The adjustment is handled through the Social Security Administration, using a short form commonly called SSA-44. The form lets you explain what changed, when it changed, and what your income looks like now.
You’re not required to prove your income down to the dollar. You’re simply explaining that you stopped working and that your income has come down as a result. A retirement letter, final paystub, or pension start notice is usually enough.
Once Social Security processes the request, Medicare typically lowers the Part B premium going forward. If you’ve already overpaid, the excess is usually refunded or credited.
This issue almost always appears in the first year or two after retirement. That’s when the gap between “old income” and “new reality” is widest.
You’ve moved on, but Medicare is still living two years in the past.
If no one catches it, retirees can quietly overpay thousands of dollars before the system eventually corrects itself.
This is a good reminder that retirement planning isn’t just about investments or withdrawal rates. It’s also about understanding how the surrounding systems work and where they lag behind real life.
Medicare rules aren’t intuitive. They’re mechanical. And sometimes they need a nudge.
If you or someone you care about recently retired and received a Medicare premium that doesn’t seem to make sense, it’s worth slowing down before assuming it’s permanent. In many cases, it isn’t.
Sometimes, the fix is simply knowing that you’re allowed to ask the question.