IRMAA 2026: Medicare's Income Surcharge Explained
Higher-income Medicare beneficiaries pay more for Part B and Part D. Here are the 2026 IRMAA brackets, how to appeal if your income has dropped, and planning strategies to reduce or eliminate the surcharge.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds set by the Social Security Administration.
Most Medicare beneficiaries pay the standard Part B premium ($202.90/month in 2026). But if your income is above the threshold, you pay the standard premium plus an IRMAA surcharge — which can add hundreds of dollars per month to your Medicare costs.
$202.90
Standard Part B premium/month (2026)
+$419
Maximum IRMAA surcharge/month (highest tier)
$622
Total Part B premium at highest IRMAA tier
IRMAA applies to both Part B and Part D. If you are subject to IRMAA, you pay a surcharge on top of your Part B premium AND on top of your Part D drug plan premium. The surcharges are separate and cumulative.
2026 IRMAA Brackets — Medicare Part B
Based on your 2024 Modified Adjusted Gross Income (MAGI). These brackets are for individuals filing single; married filing jointly (MFJ) thresholds are double.
| 2024 MAGI (Individual) | 2024 MAGI (MFJ) | IRMAA Surcharge | Total Part B/mo |
|---|---|---|---|
| Up to $106,000 | Up to $212,000 | $0.00 | $202.90 |
| $106,001–$133,000 | $212,001–$266,000 | $74.00 | $276.90 |
| $133,001–$167,000 | $266,001–$334,000 | $185.00 | $387.90 |
| $167,001–$200,000 | $334,001–$400,000 | $295.90 | $498.80 |
| $200,001–$500,000 | $400,001–$750,000 | $406.90 | $609.80 |
| Above $500,000 | Above $750,000 | $419.30 | $622.20 |
* 2026 brackets are estimates based on projected CMS adjustments. Confirm final amounts at ssa.gov.
2026 IRMAA Brackets — Medicare Part D
Part D IRMAA surcharges are added on top of your drug plan premium. You pay the surcharge directly to Medicare (not to your Part D plan).
| 2024 MAGI (Individual) | 2024 MAGI (MFJ) | Part D IRMAA Surcharge/mo |
|---|---|---|
| Up to $106,000 | Up to $212,000 | $0.00 |
| $106,001–$133,000 | $212,001–$266,000 | $13.70 |
| $133,001–$167,000 | $266,001–$334,000 | $35.30 |
| $167,001–$200,000 | $334,001–$400,000 | $57.00 |
| $200,001–$500,000 | $400,001–$750,000 | $78.60 |
| Above $500,000 | Above $750,000 | $85.80 |
The Two-Year Lookback — Why Your 2024 Income Affects 2026 Premiums
Social Security uses your tax return from two years prior to determine your IRMAA. For 2026 Medicare premiums, SSA looks at your 2024 MAGI. This creates a common problem for new retirees:
The New Retiree IRMAA Trap
You retire in 2025 at age 65. Your 2024 income was $180,000 (your last full working year). In 2026, you enroll in Medicare — and SSA hits you with a Tier 3 IRMAA surcharge of $295.90/month based on that 2024 income, even though your 2026 retirement income is only $60,000.
This is exactly when you should file an IRMAA appeal. See below.
2024
Tax year SSA uses
Your MAGI from this year determines your 2026 Medicare premiums
2025
Tax return filed
SSA processes your 2024 return and calculates your 2026 IRMAA tier
2026
Medicare premiums set
You pay premiums based on 2024 income — even if 2026 income is much lower
How to Appeal IRMAA
If your income has significantly decreased since the two-year lookback period due to a qualifying life-changing event, you can request that SSA use more recent income information to recalculate your IRMAA.
Qualifying Life-Changing Events for IRMAA Appeal
Complete Form SSA-44
Download Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event) from ssa.gov. Fill out your qualifying event and estimated current-year income.
Gather Documentation
Collect proof of the life-changing event (retirement letter, death certificate, divorce decree) and proof of your current income (recent pay stubs, pension statement, or a signed statement of estimated income).
Submit to Social Security
Submit Form SSA-44 and documentation to your local Social Security office in person, by mail, or by fax. You can also call SSA at 1-800-772-1213 to initiate the appeal.
Receive Determination
SSA will review your appeal and send a written determination. If approved, your IRMAA will be recalculated using your more recent income. Adjustments are typically applied to future months.
Retirement Planning Strategies to Avoid or Reduce IRMAA
The best time to plan for IRMAA is before you turn 65. These strategies can reduce your MAGI and keep you in a lower IRMAA bracket:
Roth Conversions Before Medicare Eligibility
High ImpactConverting traditional IRA funds to Roth before age 63 reduces future Required Minimum Distributions (RMDs), which count toward MAGI. Roth withdrawals in retirement do not count as MAGI. This is one of the most powerful long-term IRMAA reduction strategies.
Qualified Charitable Distributions (QCDs)
High ImpactIf you are 70.5 or older, you can donate up to $105,000/year directly from your IRA to charity as a QCD. The distribution satisfies your RMD but does NOT count as taxable income — reducing your MAGI.
Manage Capital Gains Realizations
Medium ImpactLarge capital gains from selling investments, real estate, or a business can spike your MAGI into a higher IRMAA bracket. Spreading gains over multiple years or using tax-loss harvesting can keep you below thresholds.
Time Large Income Events Carefully
Medium ImpactIf you know you will have a large income event (Roth conversion, business sale, property sale), consider timing it for a year when you are not yet on Medicare — or a year when you can appeal IRMAA due to a life-changing event.
Health Savings Account (HSA) Contributions
SituationalIf you are still working and covered by a high-deductible health plan, maximizing HSA contributions reduces your MAGI. Note: you cannot contribute to an HSA once you are enrolled in Medicare Part A or B.
Work with a financial advisor: IRMAA planning involves tax strategy, retirement income sequencing, and Medicare timing. I can help you understand how Medicare costs fit into your retirement picture and refer you to a trusted financial planner for the tax strategy side.
Frequently Asked Questions
Q.What is IRMAA?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums for higher-income beneficiaries. It is based on your Modified Adjusted Gross Income from two years prior.
Q.What are the IRMAA brackets for 2026?
For 2026, IRMAA surcharges begin for individuals with 2024 MAGI above $106,000 (MFJ: $212,000). Surcharges range from $74/month to $419.30/month for Part B, and $13.70 to $85.80/month for Part D.
Q.Can I appeal IRMAA?
Yes. If you have experienced a qualifying life-changing event (retirement, death of spouse, divorce, loss of income), you can file Form SSA-44 to request recalculation using more recent income.
Q.How can I avoid IRMAA?
Key strategies include Roth conversions before Medicare eligibility, qualified charitable distributions from IRAs, managing capital gains timing, and appealing after qualifying life events.
Q.Does IRMAA apply to Medicare Advantage plans?
Yes. IRMAA applies to your Part B premium regardless of whether you have Original Medicare, a Medigap plan, or Medicare Advantage. If you have Medicare Advantage with Part D included, the Part D IRMAA surcharge also applies.
Q.How long does IRMAA last?
IRMAA is recalculated each year based on your income from two years prior. If your income drops below the threshold, your IRMAA will be reduced or eliminated in the following year automatically.
Questions About Your Medicare Costs?
IRMAA can add hundreds of dollars per month to your Medicare bill. A free consultation helps you understand your costs and whether an appeal makes sense.
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