If your income exceeds a certain threshold, Medicare charges you more for Part B and Part D coverage each month. This extra charge is called IRMAA, short for Income-Related Monthly Adjustment Amount. For 2026, the standard Medicare Part B premium is $202.90 per month, but higher earners pay anywhere from $284.10 to $689.90 depending on their 2024 income. Understanding where you fall in the bracket table, and whether you can appeal, can save you hundreds of dollars per year.
What Is IRMAA?
IRMAA is a surcharge added to your standard Medicare Part B and Part D premiums when your Modified Adjusted Gross Income (MAGI) exceeds the base threshold. It is not a penalty for making a mistake. It is a tiered income-based adjustment that applies automatically once Social Security reviews your tax records.
The Social Security Administration (SSA) determines your IRMAA status using your income from two years prior. For 2026, that means SSA looks at your 2024 federal tax return. The IRS shares this data with SSA, so you do not need to submit your income information unless you are appealing.
IRMAA applies to:
- Medicare Part B (medical insurance covering doctor visits, outpatient services, preventive care)
- Medicare Part D (prescription drug coverage)
It does not apply to Medicare Part A or Medicare Advantage plan premiums directly, though Part D surcharges still apply if you have a Part D plan through a Medicare Advantage plan.
2026 IRMAA Income Brackets: Part B
The 2026 income thresholds are based on your 2024 MAGI. The brackets are different depending on whether you file taxes as single or married filing jointly.
| 2024 MAGI (Single) | 2024 MAGI (Married Filing Jointly) | Total 2026 Part B Premium |
|---|
| Up to $109,000 | Up to $218,000 | $202.90/mo |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10/mo |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80/mo |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50/mo |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20/mo |
| $500,000 or more | $750,000 or more | $689.90/mo |
The Part B IRMAA surcharge for 2026 ranges from $81.20 to $487.00 per month above the standard $202.90 premium.
2026 IRMAA Income Brackets: Part D
Part D surcharges are added on top of whatever premium your specific drug plan charges. The surcharge amounts are separate from your plan cost.
| 2024 MAGI (Single) | 2024 MAGI (Married Filing Jointly) | Part D IRMAA Surcharge |
|---|
| Up to $109,000 | Up to $218,000 | $0/mo |
| $109,001 to $137,000 | $218,001 to $274,000 | $14.50/mo |
| $137,001 to $171,000 | $274,001 to $342,000 | $37.50/mo |
| $171,001 to $205,000 | $342,001 to $410,000 | $60.40/mo |
| $205,001 to $499,999 | $410,001 to $749,999 | $83.30/mo |
| $500,000 or more | $750,000 or more | $91.00/mo |
Part D IRMAA is paid directly to Medicare, not to your drug plan. SSA deducts it from your Social Security benefit, or you receive a bill if you do not receive Social Security payments.
How IRMAA Works as a Cliff System
IRMAA brackets work as a cliff. If your 2024 income is $109,001 as a single filer, you do not pay a small fraction more. You jump to the full next tier and owe $284.10 per month for Part B instead of $202.90. One dollar of additional income can trigger an $81.20 monthly increase.
This matters most for people who are:
- Selling assets or real estate in retirement
- Taking large IRA or 401(k) distributions
- Receiving one-time income from a business sale or inheritance
- Converting a traditional IRA to a Roth IRA
These events can push your MAGI across a bracket boundary, triggering IRMAA for the entire following year. A financial planner who understands Medicare timing can sometimes help spread income across years to avoid a cliff jump.
Married Filing Separately: A Special Rule
If you are married but file your taxes separately, your IRMAA brackets are not the same as joint filers. Married filing separately filers follow a compressed bracket scale. Most married filing separately filers with income above $109,000 immediately jump to the highest-tier surcharge, which makes this filing status significantly more expensive for Medicare purposes in most cases.
What Triggers an IRMAA Notice?
You will receive a letter from SSA called an Initial Determination notice if your income qualifies you for IRMAA. This letter arrives before January 1 of the coverage year. The notice tells you which income bracket you fall in and what your new premium will be.
If you receive this letter and believe the income figure is incorrect or your income has since dropped, you have the right to appeal.
How to Appeal IRMAA: SSA-44 Form
If you had a significant income drop due to a qualifying life event, you can ask SSA to use more recent income rather than the two-year-old figure. The form is called SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event).
Qualifying Life-Changing Events
- Marriage, divorce, or death of a spouse
- Retirement or reduction in work hours
- Loss of income-producing property
- Loss of employer pension income due to plan termination
- Receipt of employer settlement payment
How to File an Appeal
- Download SSA-44 from ssa.gov or pick one up at your local SSA office.
- Complete the form with your current income estimate and the nature of the qualifying event.
- Gather supporting documents: retirement letter, final pay stub, death certificate, or divorce decree.
- Submit the form and documents to SSA by mail or in person at a local office.
- Call SSA at 1-800-772-1213 if you have questions about the process.
If SSA denies your SSA-44 appeal and you disagree with the decision, you can file Form SSA-561 to request reconsideration. After reconsideration, you may request a hearing with the Office of Medicare Hearings and Appeals within 60 days of a denial.
Does IRMAA Affect Medicare Advantage Plans?
If you are enrolled in a Medicare Advantage (Part C) plan, IRMAA still applies to your Part B premium. You pay Part B IRMAA in addition to any premium your Medicare Advantage plan charges. If your Advantage plan includes prescription drug coverage, Part D IRMAA also applies.
Some Medicare Advantage plans have $0 monthly premiums, but IRMAA on Part B still means you are paying at minimum $202.90 per month (or more if you owe IRMAA) directly to Medicare.
Medicare Savings Programs and IRMAA
Medicare Savings Programs (MSPs) are state-administered programs that help low-income Medicare beneficiaries pay their Part B premiums and other costs. These programs are not related to IRMAA in a direct way since IRMAA applies to higher-income beneficiaries while MSPs serve lower-income ones.
However, if your income situation changes dramatically, you may transition from paying IRMAA to qualifying for an MSP. The four MSP levels are:
- Qualified Medicare Beneficiary (QMB): Covers Part A and Part B premiums, deductibles, and copays.
- Specified Low-Income Medicare Beneficiary (SLMB): Covers Part B premiums only.
- Qualifying Individual (QI): Also covers Part B premiums only.
- Qualified Disabled Working Individual (QDWI): Covers Part A premiums for certain disabled workers.
Income limits for MSPs are much lower than IRMAA thresholds. If you experience a major income drop and want to check whether you now qualify for cost assistance rather than paying a surcharge, visit our free benefits screener.
IRMAA for 2025 vs. 2026: What Changed
For 2025, the base threshold for single filers was $106,000. For 2026, it rose to $109,000 due to inflation indexing. The standard Part B premium increased from $185.00 in 2025 to $202.90 in 2026. Part D surcharges also adjusted slightly upward across all tiers.
The top-tier threshold remains $500,000 for single filers and $750,000 for joint filers. These top brackets are not inflation-indexed and stay fixed until Congress changes them.
Year-by-Year Income Planning to Avoid IRMAA
Because IRMAA uses income from two years prior, retirees have some ability to manage their exposure with advance planning:
- Delay large IRA distributions to a year where your income is already high rather than creating a new spike.
- Roth conversions should be sized carefully to avoid crossing a bracket boundary.
- Capital gains timing from asset sales should account for MAGI impact.
- Coordinate spousal income if one spouse has pension or investment income that shifts the joint MAGI.
A two-year look-back means that decisions made in 2024 affect 2026 premiums, and decisions made in 2026 affect 2028 premiums.
Summary: 2026 IRMAA at a Glance
| Income Level (Single / Joint) | Part B Premium | Part D Surcharge |
|---|
| Up to $109K / $218K | $202.90 | $0 |
| $109K to $137K / $218K to $274K | $284.10 | $14.50 |
| $137K to $171K / $274K to $342K | $405.80 | $37.50 |
| $171K to $205K / $342K to $410K | $527.50 | $60.40 |
| $205K to $499K / $410K to $749K | $649.20 | $83.30 |
| $500K+ / $750K+ | $689.90 | $91.00 |
If you think your income has changed since 2024, or if you want to check whether you qualify for other Medicare cost assistance, use our free screener at benefitsusa.org/screener to see what programs may apply to your situation.
Frequently Asked Questions
What is IRMAA for Medicare?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge applied to Medicare Part B and Part D premiums for beneficiaries whose MAGI exceeds the base income threshold. For 2026, the threshold is $109,000 for single filers and $218,000 for married filing jointly.
What income does Medicare use to calculate IRMAA in 2026?
For 2026, Medicare uses your 2024 federal tax return to determine whether you owe IRMAA. SSA obtains this information directly from the IRS. If your 2024 income was above the threshold, you will receive an IRMAA notice before January 1, 2026.
How much is the IRMAA surcharge for 2026?
The Part B IRMAA surcharge ranges from $81.20 per month (first tier above the base) to $487.00 per month (top tier). The Part D IRMAA surcharge ranges from $14.50 to $91.00 per month. Combined, the maximum IRMAA added cost reaches $578.00 per month for the highest income tier, on top of Part D plan premiums.
Can I appeal my IRMAA determination?
Yes. If your income dropped due to a qualifying life event such as retirement, divorce, death of a spouse, or loss of income-producing property, you can file Form SSA-44 with the Social Security Administration to request that SSA use more recent income instead of the two-year-old figure.
Does IRMAA apply to Medicare Advantage plans?
IRMAA applies to your Part B premium regardless of whether you have Original Medicare or a Medicare Advantage plan. If your Medicare Advantage plan includes Part D drug coverage, the Part D IRMAA surcharge also applies. IRMAA surcharges are deducted from your Social Security check or billed separately.
What is the income limit to avoid IRMAA in 2026?
For 2026, you avoid IRMAA if your 2024 MAGI was $109,000 or less as a single filer, or $218,000 or less if married filing jointly. Income above these amounts triggers surcharges on a five-tier bracket scale.
Is IRMAA based on gross income or adjusted gross income?
IRMAA is based on MAGI, which is your Adjusted Gross Income plus certain deductions added back in, such as tax-exempt interest income. For most Medicare beneficiaries, MAGI is close to their AGI from Form 1040. If you are unsure, check line 11 of your 2024 Form 1040, then add any tax-exempt interest from line 2a.
