If your income exceeds a certain threshold, Medicare charges you more each month for Parts B and D. That extra charge is called IRMAA, the Income-Related Monthly Adjustment Amount. For 2026, the first tier kicks in at $109,000 for individual filers and $218,000 for married couples filing jointly. This article breaks down every bracket, the exact dollar amounts, and what you can do if you think your surcharge is wrong.
What Is IRMAA?
IRMAA is a surcharge that Medicare adds to your standard Part B and Part D premiums when your income is above certain thresholds. It is not a penalty. It is a built-in feature of Medicare designed to have higher earners pay a larger share of program costs.
The Social Security Administration (SSA) determines your IRMAA amount based on your Modified Adjusted Gross Income (MAGI) from two years prior. For 2026, SSA uses your 2024 federal tax return.
MAGI for Medicare purposes includes:
- Adjusted gross income from your tax return
- Tax-exempt interest income (such as from municipal bonds)
It does not include Roth distributions (in most cases) or proceeds from selling a primary home up to the exclusion limit.
The Cliff Effect
One thing many beneficiaries miss: IRMAA uses a "cliff" structure, not a gradual scale. The moment your income crosses a bracket threshold by even one dollar, you owe the full surcharge for that entire tier. There is no blending between brackets. This makes income management in the two years before Medicare enrollment particularly important for people near a threshold.
2026 IRMAA Brackets: Part B
The standard Part B premium for 2026 is $202.90 per month. Beneficiaries subject to IRMAA pay that base amount plus a surcharge.
Individual Filers and Married Filing Jointly
| 2024 MAGI (Individual) | 2024 MAGI (Married Filing Jointly) | Monthly Surcharge | Total Monthly Part B Premium |
|---|
| Up to $109,000 | Up to $218,000 | $0.00 | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $81.20 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $202.90 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $324.60 | $527.50 |
| $205,001 to $499,999 | $410,001 to $749,999 | $446.30 | $649.20 |
| $500,000 or more | $750,000 or more | $487.00 | $689.90 |
Married Filing Separately
People who file taxes as married filing separately face a compressed bracket structure with far fewer tiers and higher surcharges at lower income levels.
| 2024 MAGI (Married Filing Separately) | Monthly Surcharge | Total Monthly Part B Premium |
|---|
| Up to $109,000 | $0.00 | $202.90 |
| $109,001 to $391,000 | $446.30 | $649.20 |
| $391,000 or more | $487.00 | $689.90 |
This compressed structure is one reason financial advisors often recommend filing jointly rather than separately for high-income couples approaching Medicare age.
2026 IRMAA Brackets: Part D
Part D (prescription drug) plans have separate IRMAA surcharges. Unlike Part B, the Part D surcharge is added on top of whatever premium your specific plan charges. SSA collects the Part D IRMAA directly, not through your plan.
Individual and Married Filing Jointly
| 2024 MAGI (Individual) | 2024 MAGI (Married Filing Jointly) | Monthly Part D Surcharge |
|---|
| Up to $109,000 | Up to $218,000 | $0.00 |
| $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 $499,999 | $410,001 to $749,999 | $83.30 |
| $500,000 or more | $750,000 or more | $91.00 |
Married Filing Separately
| 2024 MAGI (Married Filing Separately) | Monthly Part D Surcharge |
|---|
| Up to $109,000 | $0.00 |
| $109,001 to $391,000 | $83.30 |
| $391,000 or more | $91.00 |
Combined Cost at Each Tier
If you are in the highest income tier and have a Part D plan, your combined IRMAA surcharges reach $578.00 per month ($487.00 for Part B plus $91.00 for Part D) on top of the standard $202.90 base premium and whatever your Part D plan charges. For a couple both enrolled in Medicare at the top tier, that is over $1,150 in surcharges per month.
The table below shows what a single filer pays in total additional costs (Part B surcharge plus Part D surcharge) at each bracket:
| Income Tier (Individual) | Total Monthly IRMAA (Parts B + D) | Annual Extra Cost |
|---|
| Up to $109,000 | $0 | $0 |
| $109,001 to $137,000 | $95.70 | $1,148.40 |
| $137,001 to $171,000 | $240.40 | $2,884.80 |
| $171,001 to $205,000 | $385.00 | $4,620.00 |
| $205,001 to $499,999 | $529.60 | $6,355.20 |
| $500,000 or more | $578.00 | $6,936.00 |
How SSA Notifies You
If your income triggers IRMAA, SSA sends a letter called an Initial Determination Notice. This notice arrives before your Medicare coverage starts (or before the new year if you are already enrolled). It states your income amount from the relevant tax year, the bracket it places you in, and the surcharge you will pay.
If you disagree with the determination, you have the right to appeal. The most common ground for appeal is a life-changing event that reduced your income after the two-year lookback period.
Life-Changing Events and IRMAA Appeals
If your income has dropped significantly since the tax year SSA used, you can request that Medicare use a more recent year instead. The IRS form to use is the Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event form (SSA-44).
Qualifying life-changing events include:
- Marriage, divorce, or legal separation
- Death of a spouse
- Work stoppage or reduction (retirement, layoff)
- Loss of income-producing property (due to disaster or fraud)
- Loss of employer pension income
- Receipt of settlement payment from employer
If your appeal is approved, SSA recalculates your IRMAA using the income from the year you specify, which can move you to a lower tier or eliminate the surcharge entirely.
Does IRMAA Apply to Medicare Advantage?
Yes. If you have a Medicare Advantage (Part C) plan, you still pay the Part B premium (including any IRMAA surcharge) in addition to any plan premium. Most Medicare Advantage plans have $0 plan premiums, but the Part B IRMAA surcharge does not disappear. It is collected separately by SSA through deduction from your Social Security benefit.
If you also have drug coverage through Medicare Advantage (MAPD plan), the Part D IRMAA surcharge still applies.
IRMAA and Medicare Supplement (Medigap) Plans
IRMAA surcharges are not applied to Medigap premiums. Those premiums are set by private insurers and are unrelated to your income. However, your total Medicare cost still goes up because Part B and Part D IRMAA is on top of everything else.
Planning Around IRMAA
Several strategies exist to manage or reduce IRMAA exposure:
Roth conversions before Medicare. Because Roth IRA distributions are generally excluded from MAGI, converting traditional IRA funds to Roth before you turn 63 (two years before Medicare at 65) can reduce future MAGI. Large conversions, however, can temporarily spike income and push you into a higher bracket in the conversion year itself.
Qualified Charitable Distributions (QCDs). If you are 70 and a half or older, you can donate up to $105,000 directly from an IRA to charity. QCDs satisfy your Required Minimum Distribution but do not count as income, which keeps MAGI lower.
Timing capital gains. Selling appreciated assets in years when your income is already elevated adds to MAGI. Spreading realizations across years or using tax-loss harvesting can help keep you below a bracket boundary.
Watch the cliff. If your projected MAGI lands just above a threshold, small adjustments (extra retirement account contributions, charitable gifts, business deductions) may drop you below the line and save thousands per year.
How to Check Your Current IRMAA Status
SSA determines your IRMAA and deducts it from your Social Security benefit or bills you directly if you are not yet receiving Social Security. You can:
- Log into your My Social Security account at ssa.gov to see your current Medicare deductions
- Call SSA at 1-800-772-1213
- Call Medicare at 1-800-MEDICARE (1-800-633-4227)
If you are new to Medicare and want to understand all the costs you will face -- including whether IRMAA applies to you -- the CoveredUSA screener can help you map out your full eligibility picture in about two minutes.
Frequently Asked Questions
What income figure does Medicare use to determine my 2026 IRMAA?
Medicare uses your 2024 MAGI, which SSA obtains from the IRS. MAGI is your adjusted gross income plus any tax-exempt interest income.
Does Social Security income count toward IRMAA?
The taxable portion of your Social Security benefit counts toward MAGI. However, Social Security benefits are taxed at different rates depending on your total income, so the exact impact varies by person.
Can IRMAA change from year to year?
Yes. SSA redetermines your IRMAA each year based on the tax return from two years prior. If your income drops, your IRMAA can decrease or disappear. If income rises, you move into a higher bracket.
What if I did not file a tax return for 2024?
If SSA cannot verify your income from IRS records, they may use an older tax year or assume the highest bracket as a precaution. You can provide documentation to correct this.
Is IRMAA deducted automatically?
If you receive Social Security benefits, IRMAA is deducted directly from your monthly benefit payment. If you are not yet collecting Social Security, SSA bills you quarterly.
Does IRMAA apply to Medicare Part A?
No. Most Medicare beneficiaries pay $0 for Part A premiums (because they paid Medicare taxes for at least 10 years of work). IRMAA only applies to Parts B and D.
Are the 2026 IRMAA brackets inflation-adjusted?
Yes. Each year CMS adjusts the income thresholds for inflation. For 2026, the brackets increased by roughly 3% from 2025 levels, while surcharge amounts increased by approximately 9%.
I retired this year and my income dropped. Can I get a lower IRMAA right away?
Yes. Retirement qualifies as a life-changing event. File SSA-44 with documentation of your retirement and new income estimate. SSA can apply a lower bracket for the current year rather than waiting for the standard two-year lookback to catch up.
Understanding IRMAA is one part of the larger picture of Medicare costs. If you are approaching Medicare age or already enrolled and want to check whether you qualify for other programs that can offset your costs -- such as Medicare Savings Programs that pay Part B premiums for lower-income beneficiaries -- check your eligibility at CoveredUSA. It takes about two minutes.
