2026 Brackets · NPN #22255420
Medicare IRMAA in 2026
If your income is above roughly $109,000 single or $218,000 joint, Medicare charges you more for Parts B and D. What surprises people is that the calculation uses income from two years ago — and that crossing a threshold by a single dollar costs the full surcharge. Here's how it works, and when you can push back.
Reviewed by Philip Smith, Licensed Insurance AgentNPN #22255420FL Lic. #G349232Updated July 2026
Quick Answer
What is IRMAA and who pays it in 2026?
IRMAA is an income-based surcharge added to Medicare Part B and Part D premiums. In 2026 it applies once modified adjusted gross income exceeds $109,000 for single filers or $218,000 for joint filers. Below that you pay the standard $202.90 Part B premium. Above it, total Part B runs from $284.10 to $689.90 per month, plus a Part D surcharge of $14.50 to $91.00. It's based on your income from two years earlier.
What You Pay in 2026
Based on your 2024 modified adjusted gross income. Several tiers step up between the first surcharge level and the top — the figures below show the standard premium and the range's endpoints.
| Income level (2024 MAGI) | Monthly Part B | Part D surcharge |
|---|---|---|
| At or below $109,000 single / $218,000 joint | $202.90 (standard) | None |
| Above $109,000 single / $218,000 joint | $284.10 | +$14.50 |
| Highest tier (about $205,000+ single / $410,000+ joint) | $689.90 | +$91.00 |
Surcharges are assessed per person. A married couple who are both on Medicare can each owe IRMAA on their own premiums.
Three Things People Get Caught By
It looks back two years
Your 2026 IRMAA is calculated from your 2024 tax return. That's why the surcharge often shows up in a year when your income has already dropped — Social Security is working from data that's two years stale.
It's a cliff, not a slope
Go one dollar over a bracket threshold and you owe the entire next-tier surcharge on both Part B and Part D. There's no gradual phase-in, which makes year-end income planning unusually valuable near a threshold.
It can be appealed
If a life-changing event cut your income — retirement, losing a job, divorce, or the death of a spouse — you can file Form SSA-44 to have IRMAA recalculated on your current income instead of the two-year-old return.
If you just retired, don't assume the bill is final
This is the single most common IRMAA situation worth acting on. You retire, your income falls sharply, and then Medicare charges you a surcharge calculated on your final full working year. Work stoppage is an explicitly recognized life-changing event — filing Form SSA-44 asks Social Security to use your current income instead. Many people pay a full year of surcharges they never actually owed simply because nobody told them the form exists.
One dollar can cost you hundreds
IRMAA thresholds are cliffs. Exceeding a bracket by any amount triggers the entire next-tier surcharge on both Part B and Part D for the full year. If your income lands near a threshold, decisions like Roth conversions, capital gains timing, or a large retirement-account withdrawal deserve a look with a tax professional before year end — the difference between just under and just over a line is real money.
IRMAA FAQs
What is IRMAA in Medicare?
IRMAA stands for Income-Related Monthly Adjustment Amount. It's a surcharge added to your Medicare Part B and Part D premiums if your income is above a set threshold. It isn't a separate bill in most cases — it's an increase to the premiums you already pay, typically deducted from your Social Security benefit. Most beneficiaries never pay IRMAA at all; it applies only above the income limits.
What are the 2026 IRMAA income limits?
For 2026, surcharges begin once your modified adjusted gross income exceeds $109,000 for single filers (and those married filing separately) or $218,000 for joint filers. Below those numbers you pay the standard Part B premium of $202.90 per month with no Part D surcharge. Above them, the surcharge steps up through several tiers, topping out for single filers above roughly $205,000 and joint filers above roughly $410,000.
How much is the IRMAA surcharge in 2026?
It depends on your tier. The standard Part B premium is $202.90 per month. With IRMAA, total Part B premiums run from $284.10 at the first surcharge tier up to $689.90 at the highest. Part D surcharges range from an additional $14.50 to $91.00 per month, added on top of whatever your drug plan charges. Both surcharges are assessed per person, so a married couple who both have Medicare can each owe them.
Why am I paying IRMAA when my income went down?
Because the calculation uses your tax return from two years earlier. Your 2026 surcharge is based on your 2024 income, so someone who retired in 2025 can be charged in 2026 on the higher income they earned while still working. This catches a lot of new retirees by surprise. If the drop was caused by a qualifying life-changing event, you can ask Social Security to use your current income instead by filing Form SSA-44 — you don't have to simply accept the higher amount.
How do I appeal or reduce my IRMAA?
File Form SSA-44 with Social Security and document the life-changing event. Qualifying events include marriage, divorce or annulment, the death of a spouse, work stoppage or reduced work hours, loss of income-producing property, loss of pension income, and certain employer settlement payments. Note that a simple drop in investment income generally does not qualify — the reduction has to stem from one of the recognized events. Filing promptly matters, since adjustments are applied going forward.
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