IRMAA: The Medicare Surcharge High-Income Seniors Need to Know About
Higher-income Medicare beneficiaries pay more for Parts B and D through IRMAA. Here is how it works, the income thresholds, and strategies to reduce your IRMAA surcharge.
IRMAA: The Medicare Surcharge High-Income Seniors Need to Know About
Most Medicare beneficiaries pay the standard Part B premium ($202.90/month in 2026). But if your income exceeds certain thresholds, you pay significantly more through the Income-Related Monthly Adjustment Amount -- IRMAA.
Many retirees are surprised by IRMAA because it's based on income from two years ago -- and a one-time income event (selling a business, taking a large IRA distribution, selling a home) can trigger a surcharge they didn't expect.
How IRMAA Works
IRMAA is a surcharge added to your Medicare Part B and Part D premiums when your Modified Adjusted Gross Income (MAGI) exceeds certain thresholds. Social Security uses your tax return from two years prior to determine your IRMAA.
2026 IRMAA thresholds (based on 2024 income):
| Individual MAGI | Joint MAGI | Part B Premium | Part D Surcharge |
|---|---|---|---|
| Up to $106,000 | Up to $212,000 | $185.00 | $0 |
| $106,001-$133,000 | $212,001-$266,000 | $285.00 | $13.70 |
| $133,001-$167,000 | $266,001-$334,000 | $367.10 | $35.30 |
| $167,001-$200,000 | $334,001-$400,000 | $449.20 | $57.00 |
| $200,001-$500,000 | $400,001-$750,000 | $531.30 | $78.60 |
| Above $500,000 | Above $750,000 | $594.10 | $85.80 |
Part D IRMAA surcharges range from $13.70 to $85.80/month on top of your plan premium.
The Two-Year Lookback Problem
IRMAA is based on your income from two years ago. This creates problems when:
- You retired and your income dropped significantly
- You had a one-time income event (Roth conversion, business sale, inheritance)
- Your spouse died and your filing status changed
The good news: You can appeal IRMAA if your income has decreased due to a "life-changing event." Qualifying events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or reduction
- Loss of income-producing property
- Employer settlement payment
How to Appeal IRMAA
File Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount -- Life-Changing Event) with your local Social Security office. You'll need to provide documentation of the life-changing event and your current (lower) income.
If approved, Social Security will use your more recent income to recalculate your IRMAA -- potentially eliminating or reducing the surcharge.
Strategies to Reduce Future IRMAA
Roth conversions: Converting traditional IRA funds to a Roth IRA increases your income in the conversion year but reduces future required minimum distributions (RMDs) -- which are taxable income that can trigger IRMAA.
Qualified Charitable Distributions (QCDs): If you're 70½ or older, you can donate up to $100,000/year directly from your IRA to charity. QCDs satisfy your RMD but are not included in your taxable income -- reducing MAGI and potentially your IRMAA bracket.
Tax-efficient withdrawal sequencing: Work with a financial advisor to sequence withdrawals from taxable, tax-deferred, and tax-free accounts to manage your MAGI and stay below IRMAA thresholds.
Timing large income events: If possible, spread large income events (Roth conversions, asset sales) across multiple years to avoid jumping into a higher IRMAA bracket.
This article is for educational purposes only and does not constitute financial or legal advice. Consult a financial advisor for personalized guidance.
Explore Topics
About the Author
William Gray
Independent Medicare BrokerUS Air Force Veteran · Florida Medicare Specialist
William Gray is an independent Medicare insurance broker based in Daytona Beach and Palm Coast, FL. A US Air Force veteran (A-10 crew chief, Germany), he spent years in corporate insurance before going independent to serve Florida seniors directly. He has helped more than 1,000 clients across Northeast Florida compare Medicare Advantage, Medigap, and Part D plans — always at no cost to the client.