2026 Medicare IRMAA: Income Limits, Part B Costs, Part D Surcharges, and How to Appeal

SSA generally determines your 2026 IRMAA using the most recent federal tax information available from the IRS. In most cases, that means your 2024 federal income tax return — the return you filed in 2025 covering tax year 2024. SSA uses the income figure reported on that return because it is the most recent complete tax year the IRS has provided to SSA at the time the determination is made.

This is why beneficiaries sometimes describe IRMAA as being based on income from 'two years ago.' The phrase is a shorthand for the tax-return timing: 2026 IRMAA uses 2024 income, which is the return filed in 2025. If the IRS has not yet provided SSA with your 2024 return, SSA may use an earlier year's return as a temporary measure and adjust later.

The practical consequence is that a beneficiary who retired in 2025 or 2026 and experienced a significant income reduction may still face IRMAA in 2026 based on higher pre-retirement income from 2024. The appeal process described below exists specifically to address this situation.

This is one of the most common and frustrating IRMAA situations. A beneficiary retires in 2025 or 2026, their income drops substantially, but SSA determines their 2026 IRMAA using their 2024 tax return — which reflects the higher income they earned while still working. The result is an IRMAA surcharge based on income they no longer have.

The Medicare program anticipates this problem. If your income has decreased or is expected to decrease significantly due to a qualifying life-changing event, you can ask SSA to use a more recent estimate of your income rather than the tax return on file. This request is made using Form SSA-44, described in the next section.

It is important to understand that SSA makes the determination — not your Medicare broker, not your insurance carrier, and not Medicare itself. An independent broker can help you understand the insurance portion of your Medicare costs and compare your coverage options, but the IRMAA determination and any appeal are handled entirely through SSA.

Form SSA-44 is the official SSA form titled 'Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event.' It is the mechanism through which a Medicare beneficiary asks SSA to use a more recent estimate of income — rather than the tax return on file — when determining IRMAA.

To use Form SSA-44, a qualifying life-changing event must have occurred that caused or is expected to cause a significant reduction in your income. SSA recognizes the following qualifying life-changing events: marriage, divorce or annulment, death of a spouse, work stoppage (including retirement), work reduction, loss of income-producing property due to a disaster or other event beyond your control, loss of pension income, and employer settlement payment.

The general process is: (1) you receive an IRMAA determination from SSA; (2) a qualifying life-changing event has occurred; (3) your income has decreased or is expected to decrease as a result; (4) you complete Form SSA-44 and provide SSA with required evidence of the event and your current or expected income; (5) SSA reviews the evidence and makes a new determination. SSA — not your broker or carrier — decides whether to approve the request.

Form SSA-44 is available at SSA.gov. You can submit it at your local Social Security office or by mail. SSA's instructions on the form explain the required documentation for each type of qualifying event.

No Medicare plan change eliminates IRMAA. IRMAA is an income-based surcharge administered by SSA — it is not a feature of any particular Medicare plan. Switching from one Medigap plan to another, switching carriers, or switching from Medicare Supplement to Medicare Advantage does not affect your IRMAA determination.

Similarly, choosing a cheaper Part D drug plan does not eliminate your Part D IRMAA surcharge. The Part D IRMAA amount is added to whatever your Part D plan premium is. A lower-premium Part D plan will reduce your plan premium, but the IRMAA surcharge is determined separately by SSA based on your income.

The only way to reduce or eliminate IRMAA is through a change in your income (which SSA will reflect in a future year's determination) or through a successful appeal using Form SSA-44 based on a qualifying life-changing event. An independent broker can help you understand your total Medicare cost picture and compare coverage options — but cannot change your IRMAA determination.