Medicare Part B IRMAA brackets for 2026 kick in once your 2024 modified adjusted gross income (MAGI) topped $109,000 as a single filer or $218,000 filing jointly. Cross that line and your monthly Part B premium jumps from the standard $202.90 to somewhere between $284.10 and $689.90, depending on how far into the brackets your income falls. The surcharge is called IRMAA, the Income Related Monthly Adjustment Amount, and it applies to both Part B and Part D premiums using the same income tiers.
Here is the full breakdown, exactly how the two-year lookback works, and what to do if your income has since dropped.
What Is IRMAA?
IRMAA stands for Income Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B and Part D premiums if your income exceeds a set threshold. Social Security determines your IRMAA tier using the tax return you filed two years before the coverage year, so 2026 premiums are based on 2024 income.
About 8% of Medicare Part B enrollees pay an IRMAA surcharge in a typical year, according to CMS data, but that share has grown as the income thresholds have not always kept pace with wage growth for higher earners.
2026 Medicare Part B IRMAA Brackets
The standard Part B premium for 2026 is $202.90 per month. Above that, five IRMAA tiers apply based on your 2024 MAGI.
| 2024 MAGI (Single) | 2024 MAGI (Married Filing Jointly) | 2026 Part B Monthly Premium |
|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 |
| $205,001 to $500,000 | $410,001 to $750,000 | $649.20 |
| Above $500,000 | Above $750,000 | $689.90 |
If you are married but filed a separate return from your spouse, the brackets work differently. Income of $109,000 or less pays the standard premium, income from roughly $109,001 up to approximately $391,000 pays $649.20, and income above approximately $391,000 pays the top tier of $689.90. There is no middle ground for married filing separately, which is one reason some couples choose to file jointly even when it does not otherwise help their tax bill.
2026 Part D IRMAA Surcharges
The same income brackets add a surcharge on top of your Part D prescription drug plan premium, whether you have a standalone Part D plan or Medicare Advantage with drug coverage.
| 2024 MAGI (Single) | 2024 MAGI (Married Filing Jointly) | Monthly Part D Surcharge |
|---|
| $109,000 or less | $218,000 or less | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $60.40 |
| $205,001 to $500,000 | $410,001 to $750,000 | $83.30 |
| Above $500,000 | Above $750,000 | $91.00 |
This amount is added directly to whatever your Part D plan already charges. It does not replace your plan premium.
Why Your 2024 Income Sets Your 2026 Premium
Social Security uses a two-year lookback because your most recent tax return is not yet available when premiums are set each fall. Your 2024 return, filed in 2025, is the most current complete data the Social Security Administration has when it calculates your 2026 IRMAA tier.
This means a high-income year in 2024, even a one-time event like a large capital gain, retirement account withdrawal, or the sale of a home, can trigger a Part B and Part D surcharge in 2026 even if your income has since gone back down. It also means income in 2026 will not affect your premium until 2028.
How Crossing a Bracket Works
IRMAA brackets are cliff brackets, not marginal brackets like federal income tax. If your MAGI is $1 over a threshold, you pay the full higher premium for the entire year, not just on the amount over the line. A single filer earning $109,001 in 2024 pays $284.10 a month in 2026, the same as someone earning $136,999. That is an extra $974 a year compared to someone who stayed at $109,000 even by a single dollar.
This is why year-end tax planning matters for anyone near a bracket edge. Timing a Roth conversion, capital gain, or IRA withdrawal to land just under a threshold can avoid an entire year of higher premiums for both spouses on Medicare.
What Counts as MAGI for IRMAA
MAGI for IRMAA purposes is your adjusted gross income plus tax-exempt interest income. It includes:
- Wages, self-employment income, and pensions
- Taxable Social Security benefits
- Capital gains, including one-time gains from selling a home or investment property
- Traditional IRA and 401(k) withdrawals, including Roth conversions
- Rental and investment income
- Tax-exempt municipal bond interest
Roth IRA withdrawals of contributions and qualified distributions are generally not counted, which is one reason financial planners often recommend Roth conversions before retirement, done carefully to avoid pushing income into a higher IRMAA bracket in the conversion year itself.
How to Appeal or Reduce Your IRMAA
If your 2024 income was inflated by a circumstance that no longer applies, you do not have to accept the higher premium. Social Security allows you to request a new determination using Form SSA-44, "Medicare Income Related Monthly Adjustment Amount, Life-Changing Event."
Qualifying life-changing events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or reduction in work hours
- Loss of income-producing property beyond your control
- Loss of pension income
- An employer settlement payment
- A correction to Social Security's income data if it used the wrong tax year
If you believe Social Security is using outdated or incorrect income data, for example if your 2024 return has since been amended, you can request a new determination based on updated tax information without needing a life-changing event.
To file, submit Form SSA-44 with supporting documentation to your local Social Security office. You can also call Social Security directly at 1-800-772-1213 to start the process. If a life-changing event applies, bring documentation such as a signed statement, tax return, divorce decree, or termination letter.
If Social Security denies your request, you can appeal through a formal reconsideration, and if that is unsuccessful, request a hearing with the Office of Medicare Hearings and Appeals (OMHA).
Step-by-Step: What to Do If You Just Got an IRMAA Notice
- Read the determination letter carefully. It states which tax year Social Security used and your new premium amount.
- Check if the income is accurate. Confirm the tax year and MAGI figure match your actual return.
- Determine if you have a qualifying life-changing event. Review the list above.
- Gather documentation. Tax returns, termination letters, marriage or divorce records, or a signed statement explaining the change.
- Complete Form SSA-44. Available on the Social Security Administration website.
- Submit to your local Social Security office in person, by mail, or by fax.
- Wait for a new determination, typically within a few weeks, and continue paying your current premium until you receive it.
IRMAA and Medicare Advantage or Part D Plans
IRMAA applies regardless of whether you have Original Medicare with a supplement, or a Medicare Advantage plan. If you have Medicare Advantage with drug coverage, you still pay both your Part B premium (plus any IRMAA surcharge) and a separate Part D IRMAA surcharge on top of your plan's premium, even if your Medicare Advantage plan premium itself is $0.
Frequently Asked Questions
What income triggers IRMAA in 2026?
IRMAA applies once your 2024 MAGI exceeds $109,000 as a single filer or $218,000 for married couples filing jointly. Income at or below those amounts pays the standard $202.90 Part B premium with no Part D surcharge.
How much extra do I pay if I'm in the highest IRMAA bracket?
The highest 2026 tier applies to single filers earning above $500,000 and joint filers above $750,000. Their Part B premium is $689.90 a month, plus a $91.00 Part D surcharge, for a combined $780.90 a month per person before any plan premium.
Does IRMAA apply to both spouses?
Yes. If both spouses are enrolled in Medicare, each pays their own IRMAA surcharge based on the household's combined MAGI, applied separately to each person's premium.
Can I appeal IRMAA if I retired after my 2024 tax return?
Yes, retirement or a reduction in work hours is a qualifying life-changing event. File Form SSA-44 with documentation showing your work stoppage and estimated current income.
Will my IRMAA bracket change every year?
Yes. Social Security recalculates your IRMAA tier annually using your tax return from two years prior. A high-income year followed by a lower-income year will eventually lower your premium once that lower-income return becomes the lookback year.
Is IRMAA the same for Part B and Part D?
The income brackets are identical, but the dollar surcharges differ. Part B IRMAA is added to a flat national premium. Part D IRMAA is added to whatever your specific plan charges, so your total Part D cost varies by plan even within the same IRMAA tier.
Do IRMAA brackets increase every year?
Most IRMAA thresholds are adjusted annually for inflation, though Congress has occasionally frozen or changed them. The $500,000 and $750,000 top-tier thresholds for single and joint filers are not inflation-indexed and have stayed fixed since 2018.
