Quick Answer
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to your Medicare Part B and/or Part D premiums if your Modified Adjusted Gross Income (MAGI) from two years ago exceeded $109,000 (single) or $218,000 (married filing jointly) in 2026. The surcharge ranges from $81.20 to $487.00/month for Part B and $14.50 to $91.00/month for Part D.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| No IRMAA (Income ≤ $109,000 single / $218,000 joint) | Standard Part B premium only: $202.90/month | No surcharge; pay standard premium |
| IRMAA Bracket 1 ($109,001–$137,000 single) | $284.10/month Part B total (+$81.20 surcharge) | Part D surcharge: +$14.50/month |
| IRMAA Bracket 3 ($137,001–$171,000 single) | $405.80/month Part B total (+$202.90 surcharge) | Part D surcharge: +$37.50/month |
| IRMAA Bracket 5 (≥$500,000 single / ≥$750,000 joint) | $689.90/month Part B total (+$487.00 surcharge) | Part D surcharge: +$91.00/month; top bracket frozen until 2028 |
Understanding Your Coverage Options
How IRMAA Works
IRMAA is a surcharge — not a separate plan — added on top of your standard Medicare Part B and Part D premiums. It is calculated by the Social Security Administration (SSA) based on your Modified Adjusted Gross Income (MAGI) from two years prior.
For 2026, the SSA uses your 2024 tax return to determine if you owe IRMAA. This two-year lookback is important: a high-income year two years ago can trigger IRMAA even if your income is now lower.
What It Covers
- Applies to Medicare Part B (medical insurance) premiums
- Applies to Medicare Part D (drug plan) premiums
- Also applies to Medicare Advantage plans that include drug coverage (MA-PD)
- Calculated on a sliding scale with 5 income brackets
What It Doesn't Cover
- Does not apply to Medicare Part A
- Does not apply to Medigap (Medicare Supplement) premiums
- Does not apply to Medicare Advantage plan premiums directly (but Part B IRMAA still applies)
The Cliff Effect
IRMAA uses cliff brackets: just $1 over a threshold triggers the full surcharge for that bracket. For example, earning $109,001 instead of $109,000 as a single filer adds $81.20/month to your Part B premium — $974.40 more per year.
2026 IRMAA Brackets: Part B
The standard 2026 Part B premium is $202.90/month. If your 2024 MAGI exceeded the threshold, you pay the standard premium plus the IRMAA surcharge shown below.
The brackets are adjusted annually for inflation (except the top bracket, which is frozen until 2028). Your 2026 IRMAA is based on your 2024 income.
What It Covers
- ≤ $109,000 (single) / $218,000 (joint): $0 surcharge — pay $202.90/month
- $109,001–$137,000 / $218,001–$274,000: +$81.20 — pay $284.10/month
- $137,001–$171,000 / $274,001–$342,000: +$202.90 — pay $405.80/month
- $171,001–$205,000 / $342,001–$410,000: +$324.60 — pay $527.50/month
- $205,001–$499,999 / $410,001–$749,999: +$446.30 — pay $649.20/month
- ≥ $500,000 (single) / $750,000 (joint): +$487.00 — pay $689.90/month
What It Doesn't Cover
- Married filing separately has narrower brackets — jumps directly from $0 to $446.30 surcharge at $109,001
2026 IRMAA Brackets: Part D
If you have a Medicare Part D drug plan (or a Medicare Advantage plan with drug coverage), you also pay a Part D IRMAA surcharge on top of your plan's premium. The Part D IRMAA is paid directly to Medicare, not to your plan.
What It Covers
- ≤ $109,000 (single) / $218,000 (joint): $0 Part D surcharge
- $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 (single) / $750,000 (joint): +$91.00/month
What It Doesn't Cover
- Part D IRMAA is in addition to your plan's monthly premium
- If you don't have Part D, you don't owe Part D IRMAA
IRMAA is Deducted from Social Security
If you receive Social Security benefits, your IRMAA surcharge is automatically deducted from your monthly Social Security payment. If you don't receive Social Security, you'll receive a bill from Medicare.
What Income Counts toward IRMAA (MAGI)
IRMAA is based on your Modified Adjusted Gross Income (MAGI), which is your Adjusted Gross Income (AGI) plus tax-exempt interest income. For most people, MAGI equals Line 11 of Form 1040 plus Line 2a (tax-exempt interest).
Many retirees are surprised to find that certain income sources push them into an IRMAA bracket, including Roth conversions, Required Minimum Distributions (RMDs), and the sale of a home or investments.
What It Covers
- Wages and salaries
- Taxable Social Security benefits
- Traditional IRA/401(k) withdrawals and RMDs
- Capital gains (including home sales)
- Roth IRA conversions (in the year of conversion)
- Pension and annuity income
- Tax-exempt interest (municipal bonds, etc.)
What It Doesn't Cover
- Qualified Roth IRA withdrawals do NOT count toward MAGI
- Health Savings Account (HSA) distributions for qualified medical expenses
- Life insurance proceeds
How to Appeal IRMAA
If your income has decreased due to a qualifying life-changing event, you can appeal your IRMAA determination and request a reduction. The SSA will use more recent income data instead of the two-year-old tax return.
To appeal, complete Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event) and submit it to your local Social Security office with supporting documentation.
What It Covers
- Marriage, divorce, or death of spouse
- Work stoppage or reduction (retirement)
- Loss of income-producing property (disaster, fraud)
- Loss of pension income
- Employer settlement payment
What It Doesn't Cover
- A one-time spike in income (e.g., selling a home) is not a qualifying event
- Voluntary income reduction without a qualifying life event
- Appeals must be submitted with documentation
How to Appeal
Submit Form SSA-44 to your local Social Security office or call 1-800-772-1213. You can also request a reconsideration online at ssa.gov. Provide documentation of the life-changing event and your current income.
2026 IRMAA Surcharges: Part B and Part D Combined
| Income (Single Filer) | Income (Joint Filer) | Part B Total Premium | Part D Surcharge |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | +$14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | +$37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | +$60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | +$83.30 |
| ≥ $500,000 | ≥ $750,000 | $689.90 | +$91.00 |
✦ Important Exceptions & Special Situations
Married Filing Separately
Couples who file taxes separately face much harsher IRMAA brackets. Income above $109,000 jumps directly to the 4th bracket ($446.30/month Part B surcharge), skipping brackets 1-3. Only the top bracket ($500,000+) is different.
Filing separately can dramatically increase your IRMAA. Consider tax filing strategy carefully.
New Medicare Enrollees
If you're new to Medicare and your income has recently dropped (e.g., you just retired), you can proactively request that SSA use your current year's income instead of the two-year-old tax return by submitting Form SSA-44.
Roth Conversions and IRMAA
Converting a traditional IRA to a Roth IRA increases your MAGI in the year of conversion, potentially triggering or increasing IRMAA two years later. However, future Roth withdrawals won't count toward MAGI, reducing long-term IRMAA exposure.
Medicare Advantage and IRMAA
If you have Medicare Advantage, you still owe the Part B IRMAA surcharge in addition to any plan premium. If your MA plan includes drug coverage (MA-PD), you also owe the Part D IRMAA surcharge.
✦ Recent Policy Updates
2026 IRMAA Brackets Increased ~3%
PassedCMS announced 2026 IRMAA income thresholds increased approximately 3% due to inflation adjustments. The lowest IRMAA bracket now starts at $109,000 for single filers (up from $106,000 in 2025).
Top IRMAA Bracket Frozen until 2028
PassedThe 5th IRMAA bracket ($500,000+ single / $750,000+ joint) is currently frozen and cannot be indexed for inflation until 2028 under current law. All other brackets are inflation-adjusted annually.
Part B Premium Increased to $202.90 in 2026
PassedThe standard Medicare Part B premium increased to $202.90/month in 2026 (from $185.00 in 2025). IRMAA surcharges are added on top of this standard amount.
Strategies to Reduce or Avoid IRMAA
Because IRMAA uses a two-year lookback, the best time to manage it is before you reach Medicare age — ideally 2-3 years before you turn 65.
IRMAA Planning Checklist
- Understand your MAGI two years before Medicare enrollment
- Consider Roth conversions in low-income years before Medicare to reduce future RMDs
- Coordinate large one-time income events (home sales, Roth conversions) carefully
- If income dropped due to a qualifying life event, file Form SSA-44 immediately
- Use tax-advantaged accounts (HSA, QCDs for RMDs) to reduce MAGI
- Work with a financial advisor on retirement income sequencing to stay below IRMAA thresholds
- Review your IRMAA determination letter from SSA each fall for the upcoming year
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed insurance agent and Medicare specialist at MedicareFAQ.com.
Ashlee Zareczny
ReviewerAshlee Zareczny is the Compliance & Editorial Manager at MedicareFAQ.