Irmaa 2025 Application Form. Irmaa information instruction form (nyc.gov) please note: To be reimbursed for irmaa, you must complete the irmaa reimbursement request application (below) and submit it to the employee benefits division along with proofs of.

Your brief profile and application. Irmaa applies in 2025 if your modified adjusted gross income from 2022 is above these thresholds: