Medicare IRMAA Brackets 2026: Income Thresholds and Surcharges
Medicare IRMAA Brackets 2026: Income Thresholds and Surcharges
IRMAA — the Income-Related Monthly Adjustment Amount — is a surcharge on top of your standard Medicare premiums if your income exceeds certain thresholds. It applies to both Part B and Part D, and it's based on your Modified Adjusted Gross Income from two years prior.
For 2026 premiums, CMS uses your 2024 federal tax return.
2026 Part B IRMAA Brackets
| Individual MAGI (2024) | Joint MAGI (2024) | Monthly Part B premium |
|---|---|---|
| ≤$109,000 | ≤$218,000 | $202.90 (standard) |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 |
| ≥$500,000 | ≥$750,000 | $689.90 |
At the highest bracket, you're paying $689.90/month — more than triple the standard premium. That's $8,278.80/year just for Part B.
2026 Part D IRMAA Surcharges
IRMAA also adds a flat surcharge to your Part D prescription drug plan premium:
| Individual MAGI (2024) | Joint MAGI (2024) | Part D IRMAA surcharge |
|---|---|---|
| ≤$109,000 | ≤$218,000 | $0 (plan premium only) |
| $109,001–$137,000 | $218,001–$274,000 | +$14.50/month |
| $137,001–$171,000 | $274,001–$342,000 | +$37.50/month |
| $171,001–$205,000 | $342,001–$410,000 | +$60.40/month |
| $205,001–$499,999 | $410,001–$749,999 | +$83.30/month |
| ≥$500,000 | ≥$750,000 | +$91.00/month |
This surcharge is on top of whatever your Part D plan's base premium is.
How IRMAA Is Calculated
SSA pulls your Modified Adjusted Gross Income directly from IRS records — specifically, your adjusted gross income plus tax-exempt interest income. You don't need to report anything; the determination happens automatically.
The two-year lookback means 2026 premiums are based on 2024 income. If you had a high-income year because of a one-time event — selling a business, a large Roth conversion, exercising stock options — you'll pay higher premiums two years later even if your current income is much lower.
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Appealing IRMAA: Form SSA-44
If your income has dropped significantly due to a qualifying life-changing event, you can request a reduction by filing Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life Changing Event) with your local SSA office.
Qualifying events include:
- Retirement or reduction in work hours
- Marriage, divorce, or annulment
- Death of a spouse
- Loss of income-producing property (due to disaster, fraud, or other cause beyond your control)
- Loss of pension
You'll need documentation — a letter from your employer confirming retirement, a divorce decree, a death certificate, or pension termination notice. SSA will recalculate using your projected current-year income instead of the two-year-old tax return.
This appeal is well worth filing. Someone who retired in 2025 with $80,000 in current income but had $180,000 on their 2024 return would be paying $284.10/month instead of $202.90 — an extra $974.40/year — without the appeal.
Planning Ahead: Roth Conversions and IRMAA
If you're doing Roth IRA conversions before Required Minimum Distributions kick in, those conversions count as income and can push you into a higher IRMAA bracket two years later. Some retirees spread conversions across multiple years specifically to stay below the $109,000/$218,000 threshold.
The Medicare Enrollment Guide includes the complete IRMAA bracket tables, a walkthrough of the SSA-44 appeal process, and strategies for managing income in the years before and after Medicare enrollment.
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