What IRMAA is — and why it surprises people
Most people on Medicare pay the standard Part B premium. But if your income is above a threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA) — a surcharge added to both your Part B premium and your Part D drug coverage. It catches people off guard for two reasons: it’s based on your income from two years ago, and it works as a “cliff” — going even one dollar over a bracket moves you to the higher amount for the whole year.
💡 Watch the two-year lookback
⚠ Estimate only — SSA makes the official determination
MAGI is your adjusted gross income plus any tax-exempt interest.
2026 IRMAA brackets (full table)
| Single MAGI | Joint MAGI | Part B / mo | Part D / mo |
|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 | $0.00 |
| $109,000–$137,000 | $218,000–$274,000 | $284.10 | $14.50 |
| $137,000–$171,000 | $274,000–$342,000 | $405.80 | $37.50 |
| $171,000–$205,000 | $342,000–$410,000 | $527.50 | $60.40 |
| $205,000–$500,000 | $410,000–$750,000 | $649.20 | $83.30 |
| Over $500,000 | Over $750,000 | $689.90 | $91.00 |
Source: Centers for Medicare & Medicaid Services — 2026 Medicare Part B & Part D premiums / IRMAA (published November 2025). Figures cross-verified across two published tables. Married-filing-separately uses a separate schedule — contact SSA. Amounts change yearly; confirm with SSA or Medicare.
Medicare IRMAA — FAQ
What is IRMAA?
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IRMAA (the Income-Related Monthly Adjustment Amount) is a surcharge that higher-income Medicare beneficiaries pay on top of the standard Part B premium and their Part D drug-plan premium. About 7–8% of Medicare beneficiaries pay it. It is not a separate bill you can decline — the Part B portion is deducted from Social Security or billed to you, and the Part D portion is billed by Medicare in addition to your drug plan's own premium.
What income determines 2026 IRMAA?
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2026 IRMAA is based on your modified adjusted gross income (MAGI) from your 2024 federal tax return — a two-year lookback. MAGI is your adjusted gross income plus any tax-exempt interest. Because it looks back two years, a one-time income spike (a large capital gain, a Roth conversion, or the sale of a home or business) two years ago can raise this year's Medicare premiums.
What are the 2026 IRMAA income thresholds?
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For 2026, IRMAA begins above $109,000 MAGI for single filers and $218,000 for married filing jointly, then rises through five brackets. The Part B premium ranges from the standard $202.90 up to $689.90 per month, and the Part D surcharge ranges from $14.50 to $91.00 per month, at the top bracket ($500,000 single / $750,000 joint). Married-filing-separately uses a separate schedule.
Can I lower or appeal my IRMAA?
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Yes, in specific situations. If your income has dropped because of a life-changing event — retirement or reduced work hours, marriage, divorce, the death of a spouse, or loss of a pension — you can ask the Social Security Administration to use more recent income by filing Form SSA-44. You can also plan ahead: because IRMAA is a hard 'cliff,' keeping MAGI just under a bracket threshold (through the timing of Roth conversions, capital gains, or withdrawals) can avoid a surcharge entirely.
Does IRMAA apply if I have Medicare Advantage or a standalone Part D plan?
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Yes. The Part B IRMAA applies no matter how you get your coverage, because everyone on Medicare pays a Part B premium — including Medicare Advantage members. The Part D IRMAA surcharge applies whenever you have drug coverage, whether through a standalone Part D plan or a Medicare Advantage plan that includes drugs, and it is paid to Medicare separately from your plan's premium.
Related guides and tools
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed July 2026
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