If you’re a Missouri Medicare beneficiary paying higher-than-standard Part B or Part D premiums in 2026, you may be paying an Income-Related Monthly Adjustment Amount — known as IRMAA. And if your income has dropped significantly since the year your IRMAA was calculated, you may be able to appeal and get that surcharge reduced or eliminated entirely.
I’ve helped multiple Missouri clients successfully appeal their IRMAA determinations after retirement. The process is straightforward once you understand how it works — but most people don’t know it exists.
What Is IRMAA and How Does It Affect Missouri Medicare Beneficiaries?
IRMAA is a surcharge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. In 2026, IRMAA applies to individuals with a modified adjusted gross income above $109,000 (or $218,000 for married couples filing jointly), based on your 2024 tax return.
The standard Part B premium in 2026 is $202.90 per month. With IRMAA, that premium can increase significantly depending on your income bracket. The 2026 IRMAA surcharges add between $73.90 and $443.90 per month to your Part B premium — on top of the standard $202.90. For Part D, IRMAA adds between $13.70 and $85.80 per month on top of your plan’s regular premium.
For Missouri residents in higher income brackets — particularly retirees from high-earning careers in the Kansas City metro area — IRMAA can add hundreds of dollars per month to Medicare costs. Use our free 2026 IRMAA Calculator to see exactly which bracket you’re in and how much you’re paying.
Why Would Missouri Retirees Qualify for an IRMAA Appeal?
Social Security uses your tax return from two years prior to calculate your IRMAA. In 2026, they’re looking at your 2024 income. This creates a timing problem for people who recently retired or experienced a significant income drop.
If you earned $200,000 in 2024 but retired in early 2025 and now live on Social Security and investment income totaling $85,000 per year, Social Security doesn’t automatically know your income dropped. They’ll continue charging you IRMAA based on the 2024 return — until you appeal.
The life events that qualify you for an IRMAA appeal in Missouri include:
Marriage, divorce, or death of a spouse — any change in filing status that affects your household income calculation.
Work reduction or stoppage — retirement, reduced hours, or leaving a job. This is the most common qualifying event I see among Missouri clients.
Loss of income-producing property — sale of a business, foreclosure, or loss of rental income.
Loss of pension income — termination of an employer pension or annuity.
Employer settlement payment — one-time payments that inflated income in a prior year but won’t recur.
If any of these apply to you, you likely qualify for an appeal.
What Is the SSA-44 Form and How Do You Use It?
The SSA Form SSA-44 is the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event form. It’s the official document you submit to Social Security to request a recalculation of your IRMAA based on more recent income information.
The SSA-44 asks you to identify the qualifying life-changing event, provide the year the event occurred, and supply an estimate of your current year’s income. You’ll also need to provide documentation supporting your income estimate — typically a copy of your most recent tax return, a letter from your employer confirming retirement, or other relevant documentation.
You can submit the SSA-44 in person at your local Social Security office, by mail, or in some cases online. For Missouri residents in the Kansas City area, the Kansas City SSA office is located at 2300 Main St, Kansas City, MO 64108. You can also call Social Security at 1-800-772-1213 to initiate the process by phone.
Step-by-Step: How to Appeal IRMAA in Missouri
Here is the process I walk Missouri clients through when filing an IRMAA appeal.
Step 1: Confirm your IRMAA determination. Check your Medicare premium notice or your Social Security benefit statement to confirm you’re paying IRMAA and identify which income bracket you’ve been placed in. Social Security mails IRMAA determination notices annually — if you didn’t receive one or can’t find it, call Social Security at 1-800-772-1213.
Step 2: Identify your qualifying life event. Review the list of qualifying events and identify which one applies to your situation. Retirement is the most common, but any significant income reduction tied to one of the qualifying events is worth pursuing.
Step 3: Download and complete SSA Form SSA-44. The form is available at ssa.gov. Complete all sections carefully. In the income estimate section, use your best estimate of your current year’s income — not your prior year’s income that triggered the IRMAA.
Step 4: Gather supporting documentation. For retirement, this typically means a letter from your former employer confirming your retirement date or your final pay stub. For other qualifying events, gather documentation appropriate to your situation — divorce decree, death certificate of spouse, documentation of pension termination, etc.
Step 5: Submit the form and documentation. Submit to your local Social Security office in person for the fastest processing, or mail to the address on the form. Keep copies of everything you submit.
Step 6: Follow up. Social Security typically processes IRMAA appeals within 30–60 days. If you submitted in person, you may receive a decision before you leave. Follow up by phone if you haven’t received a response within 60 days.
Step 7: If approved, confirm your new premium. Once approved, Social Security will recalculate your premium based on your estimated current income and issue a new determination. The adjustment typically takes effect the month after approval.
How Much Can a Successful IRMAA Appeal Save Missouri Retirees?
The savings depend on which IRMAA bracket you’re in and what your income drops to after the qualifying event.
A Missouri resident who was in the second IRMAA tier in 2026 — paying an additional $184.00 per month on Part B plus Part D surcharges — and successfully appeals to below the IRMAA threshold would save over $200 per month. That’s more than $2,400 per year, and the savings compound over multiple years of retirement.
I’ve worked with Lee’s Summit and Overland Park clients who saved $150–$300 per month through successful IRMAA appeals after retiring from high-earning careers. In every case, the time invested in the SSA-44 process was well worth the outcome.
What If Social Security Denies Your IRMAA Appeal?
If Social Security denies your initial IRMAA appeal, you have the right to request a formal hearing. The denial notice will include information about your appeal rights and the deadline for requesting a hearing — typically 60 days from the date of the denial notice.
At the hearing level, you can present additional documentation and make your case directly to an administrative law judge. While most well-documented IRMAA appeals are approved at the initial level, the hearing option exists as a backstop if your initial appeal is denied for any reason.
If your appeal is denied and you believe the denial is incorrect, consulting with a Medicare advisor or elder law attorney who handles Social Security matters can help you evaluate whether a hearing is worth pursuing.
Roth Conversions and IRMAA: A Missouri Planning Consideration
One area where Missouri retirees often inadvertently trigger IRMAA is through Roth IRA conversions. Converting a traditional IRA to a Roth IRA generates taxable income in the year of conversion — and if that conversion pushes your MAGI above the IRMAA threshold, you’ll face a surcharge two years later.
This is an area where coordination between your tax advisor and your Medicare advisor matters. A large Roth conversion in 2024 that pushes your income above $109,000 will generate IRMAA in 2026. If that was a one-time conversion and your income returns to below the threshold in 2025, you can appeal your 2027 IRMAA based on the 2025 income — but the 2026 surcharge from the conversion year generally cannot be appealed unless a separate qualifying life event occurred.
For Missouri retirees doing Roth conversion planning in the Kansas City metro area, I recommend discussing the Medicare premium implications with your financial advisor before executing large conversions.
Use Our Free 2026 IRMAA Calculator
Before filing an appeal, use our free 2026 IRMAA Calculator to confirm exactly which bracket you’re in, see your annual surcharge amount, and model what-if scenarios like Roth conversions or capital gains events. The calculator uses official 2026 CMS figures and includes the full bracket table for single, married filing jointly, and married filing separately filers.
Frequently Asked Questions
How do I know if I’m paying IRMAA in Missouri?
Check your Medicare premium amount. In 2026, the standard Part B premium is $202.90 per month. If you’re paying more than that, you’re paying IRMAA. Social Security should have sent you an IRMAA determination notice. If you didn’t receive one, call 1-800-772-1213. You can also use our free IRMAA Calculator to check your bracket.
Can I appeal IRMAA if I just retired this year?
Yes — retirement is one of the qualifying life events for an IRMAA appeal. If you retired in 2025 or 2026 and your income dropped significantly, you can file an SSA-44 with documentation of your retirement and an estimate of your current income to request a recalculation.
How long does an IRMAA appeal take in Missouri?
Most IRMAA appeals processed through the Kansas City Social Security office take 30–60 days. In-person submissions often result in same-day or next-day decisions. Mail submissions take longer. Follow up by phone at 1-800-772-1213 if you haven’t received a response within 60 days.
Does IRMAA apply to Medicare Advantage premiums?
IRMAA applies to Medicare Part B and Part D premiums. If you’re enrolled in a Medicare Advantage plan with a $0 premium, you still pay the Part B premium — and if you’re subject to IRMAA, you pay the IRMAA-adjusted Part B premium. IRMAA does not directly affect your Medicare Advantage plan’s monthly premium beyond the Part B surcharge.
What income is used to calculate IRMAA?
IRMAA is calculated using your Modified Adjusted Gross Income (MAGI) from your tax return two years prior. In 2026, Social Security uses your 2024 MAGI. MAGI includes adjusted gross income plus tax-exempt interest income. It does not include Social Security benefits that are not subject to income tax.