How Much Is the Medicare Levy Surcharge? (2026 US Equivalent: IRMAA)

Direct Answer: Is There a Medicare Levy Surcharge in the US?

No, the United States has no Medicare Levy Surcharge; that is an Australian tax of 1% to 1.5% of income in the 2025-26 tax year on higher earners without private hospital cover. The closest US equivalent is the Medicare income-related monthly adjustment amount (IRMAA), which adds $81.20 to $487.00 per month to the 2026 Part B premium of $202.90 for individuals with income above $109,000.

What the Australian Medicare Levy Surcharge Actually Is (2025-26)

Australia's Medicare Levy Surcharge applies in the 2025-26 tax year to people who earn above an income threshold and do not carry appropriate private hospital cover. For singles the surcharge starts above $101,000 AUD, with 1% for the first tier, 1.25% for the second tier, and 1.5% for incomes above $158,000 AUD. Families use a higher starting threshold of $202,000 AUD. The surcharge sits on top of the standard 2% Medicare levy and is meant to push higher earners toward private hospital insurance.

Exact tiers, family thresholds, and exemptions change each Australian income year, so anyone subject to Australian tax should confirm current figures with the Australian Taxation Office at ato.gov.au. CoveredUSA covers US coverage rules, and the Australian figures above are given only to explain why the US term search returns no US result.

Why the US Has No Medicare Levy Surcharge

Original Medicare in the United States is funded differently from Australia's system. Medicare Part A is paid mainly through the 2.9% payroll tax in 2026, while Medicare Part B and Medicare Part D are funded through monthly premiums and general federal revenue. No US rule charges a tax penalty because someone lacks private hospital insurance, and people choose among Original Medicare, Medicare Advantage, and Medigap based on cost and network needs.

For people under 65, ACA-compliant marketplace plans cover essential health benefits and cannot deny coverage for a preexisting condition. The federal ACA tax penalty for lacking coverage has been $0 since 2019, so no US surcharge pushes anyone toward private insurance. A few states run their own coverage requirements, so state rules matter for people not yet on Medicare.

The Closest US Equivalent: Medicare IRMAA in 2026

Medicare IRMAA is the US income-based surcharge on Part B and Part D premiums. For 2026, Social Security uses modified adjusted gross income (MAGI) from the 2024 tax return, and IRMAA starts above $109,000 for individuals or $218,000 for married couples filing jointly. At the lowest tier the Part B total is $284.10 per month ($81.20 extra), and at the top tier, for MAGI of $500,000 or more (individuals) or $750,000 or more (joint), the total is $689.90 per month ($487.00 extra).

Part D IRMAA is billed separately in 2026 and runs from $14.50 to $91.00 per month on top of the drug plan premium. IRMAA applies whether someone has Original Medicare with a Part D plan or Medicare Advantage with drug coverage, and Medigap premiums are not affected because IRMAA attaches to Parts B and D only. Married people filing separately who lived with their spouse face the harshest brackets: $649.20 total Part B above $109,000, and $689.90 at $391,000 or more in 2026.

Alternatives and Related US Charges if You Meant an Income-Based Medicare Surcharge

Because the US has no Medicare Levy Surcharge, readers usually want one of the following US rules instead. Each is a real 2026 charge, and the right one depends on whether the concern is tax, premium, or a penalty for late enrollment. Official explanations are on Medicare.gov, SSA.gov, and IRS.gov.

• Part B and Part D IRMAA: the income-based premium surcharge described above, $81.20 to $487.00 extra per month for Part B and $14.50 to $91.00 for Part D in 2026. Details at ssa.gov and medicare.gov.
• Additional Medicare Tax: a 0.9% payroll surtax on wages above $200,000 single or $250,000 married filing jointly in 2026, reported on IRS Form 8959. See irs.gov.
• Part B late enrollment penalty: 10% of the standard premium for each full 12-month period without Part B when first eligible, charged for as long as the person has Part B. Details at medicare.gov.
• Part D late enrollment penalty: 1% of the national base beneficiary premium for each full month without creditable drug coverage, added to the monthly plan premium. Details at medicare.gov.

How to Ask Social Security to Lower Your 2026 IRMAA

People assessed IRMAA in 2026 can ask the Social Security Administration (SSA) for a new decision if income dropped because of a life-changing event, such as retirement, marriage, divorce, death of a spouse, or loss of income-producing property. SSA bases the 2026 bracket on the 2024 tax return, so a large income fall since 2024 may justify a lower bracket. Start at ssa.gov/medicare/medicare-premiums, and call SSA at 1-800-772-1213 if the online route does not fit.

Anyone who disagrees with the IRMAA decision on the facts, such as wrong tax data from the IRS, can also ask for a review. A reduced bracket applies going forward for the year in question, and SSA refunds extra premiums already withheld when the correction is approved. Use the CoveredUSA bill analyzer to estimate how much of a monthly Medicare premium or bill is IRMAA.

Is there a Medicare Levy Surcharge in the United States?

No. The Medicare Levy Surcharge is an Australian tax of 1% to 1.5% of income in the 2025-26 tax year for higher earners without private hospital cover. The US funds Medicare through payroll taxes and premiums, and the closest US rule is the income-related monthly adjustment amount (IRMAA) on Parts B and D.

How much is Medicare IRMAA in 2026?

In 2026, Part B IRMAA adds $81.20 to $487.00 per month on top of the $202.90 standard premium, for totals of $284.10 to $689.90. Part D IRMAA adds $14.50 to $91.00 per month. IRMAA begins above $109,000 MAGI for individuals and $218,000 for married couples filing jointly.

What income do they use to set my 2026 IRMAA?

Social Security uses modified adjusted gross income (MAGI) from your 2024 federal tax return to set 2026 IRMAA. MAGI is adjusted gross income plus tax-exempt interest. If 2024 data is unavailable, SSA may use the 2023 return.

Does IRMAA apply to Medicare Advantage and Medigap?

IRMAA applies to Part B and Part D premiums, including for Medicare Advantage members who still pay the Part B premium and for drug coverage. Medigap premiums are set by private insurers and carry no IRMAA, although Medigap enrollees on Original Medicare still pay IRMAA on Parts B and D.

Can I appeal an IRMAA decision?

Yes. If your income fell because of a life-changing event such as retirement, divorce, or the death of a spouse, you can ask Social Security for a new decision using the 2026 life-changing event process. You can also request a review if SSA used incorrect or outdated tax information.

Is the Additional Medicare Tax the same as IRMAA?

No. The Additional Medicare Tax is a 0.9% payroll tax on wages above $200,000 single or $250,000 married filing jointly in 2026, paid through tax filing. IRMAA is a higher monthly premium for Part B and Part D collected through Social Security or Medicare billing.

Does the US penalize people who skip private health insurance?

No federal penalty applies. The ACA individual mandate penalty has been $0 since 2019, and Medicare has no private-hospital-cover surcharge. The Part B and Part D late enrollment penalties apply to Medicare timing, not to skipping private insurance.

Where do I find the Australian Medicare Levy Surcharge rules?

The Australian Taxation Office publishes the Medicare Levy Surcharge income thresholds, rates, and exemptions at ato.gov.au for each income year. CoveredUSA covers US coverage rules only, so Australian residents should rely on the ATO for current figures.