What IRMAA Is
IRMAA stands for income-related monthly adjustment amount. Most people pay the standard Part B premium, which is $202.90 a month in 2026. If your income is above a set level, Social Security tells you that you owe an extra amount added to it, and a separate extra amount added to your Part D premium.
Social Security makes the decision and sends the notice; Medicare publishes the amounts. The Part B portion is usually deducted from your Social Security payment. The Part D portion is deducted from your Social Security payment or paid directly to Medicare, in addition to your plan premium, and it applies even if your drug coverage comes through a Medicare Advantage plan.
Which Income Counts
IRMAA uses your modified adjusted gross income (MAGI) as reported to the IRS, and it looks back two years. Your 2026 premium is based on your 2024 tax return.
That two-year lag is the trap. Someone who retires at 65 is often judged on income from the last full working year, or from a year with a large one-time item, such as a big capital gain, a Roth conversion or a lump-sum payout. The bracket edges are cliffs, too: going $1 over a threshold puts you in the higher bracket.
The 2026 IRMAA Table
| Individual return | Joint return | Total Part B premium | Part D add-on |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $60.40 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
The Part D add-on is paid in addition to whatever premium your drug plan charges. For example, someone single with 2024 MAGI of $150,000 pays $405.80 a month for Part B in 2026 plus $37.50 a month in addition to their Part D plan premium. The IRMAA calculator runs the same table for your figures.
Married Filing Separately
If you are married, lived with your spouse at any time during the tax year, and file separately, a different and steeper table applies in 2026:
| 2024 MAGI | Total Part B premium | Part D add-on |
|---|---|---|
| $109,000 or less | $202.90 | $0.00 |
| Above $109,000 and less than $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91.00 |
Appealing IRMAA With Form SSA-44
IRMAA is not always final. Social Security’s rules (POMS HI 01120.001) let you ask it to use a more recent year’s income if your income dropped because of a life-changing event. The qualifying events include:
- Marriage, divorce or annulment, or the death of a spouse
- Work stoppage or work reduction
- Loss of income-producing property
- Loss of employer pension income
- Receipt of certain employer payments
You file form SSA-44, “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event,” with documents that show the event and your more recent income. Using the form is optional; Social Security’s rules say the request can also be made verbally or in writing. If instead you think the tax information Social Security used is wrong, contact Social Security about correcting it. Note that a one-time capital gain is not on the list of life-changing events.
Planning Ahead
Because IRMAA looks back two years, decisions you make at 63 can affect your premiums at 65. Large Roth conversions, selling appreciated property, or taking a big retirement-account distribution in one year can push you into a higher bracket two years later. Spreading income across years can sometimes keep you under a threshold. That is a tax-planning conversation, so involve your tax professional before acting.
As of this guide’s review date, the 2027 Part B premium and IRMAA brackets have not been announced. CMS usually publishes them in the autumn, and they will be based on 2025 income. For the rest of the 2026 Medicare cost picture, see Medicare costs in 2026; for how IRMAA is added to drug plan premiums, see our Part D guide. If an IRMAA notice arrives while you are still deciding how to delay Part B, our working past 65 guide may help.
Got an IRMAA letter, or expecting one?
We can walk through how IRMAA affects your Medicare choices and point you to the right Social Security steps. For tax planning, bring in your tax professional too.
Request a free comparison Call 208-350-9933Frequently Asked Questions
What income is used for my 2026 IRMAA?
Social Security uses the modified adjusted gross income (MAGI) reported on your federal tax return from two years earlier, so 2026 premiums are based on 2024 income. If your income has since dropped because of a life-changing event, you can ask Social Security to use a more recent year.
What are the 2026 IRMAA thresholds?
In 2026 IRMAA starts when 2024 income is above $109,000 for an individual tax return or above $218,000 for a joint return. Above those levels, the total monthly Part B premium rises in steps from $284.10 to $689.90, and a Part D surcharge of $14.50 to $91.00 a month is added to your drug plan premium.
Can I appeal IRMAA if my income dropped?
Yes. If your income went down because of a life-changing event, such as stopping or reducing work, marriage, divorce, death of a spouse, or loss of income-producing property or employer pension income, you can ask Social Security to use more recent income by filing form SSA-44 with supporting documents. If you think the income Social Security used is simply wrong, contact Social Security about correcting it.
Have the 2027 IRMAA brackets been announced?
Not as of this guide’s review date. CMS and Social Security usually publish the next year’s Part B premium and IRMAA brackets in the autumn. The 2027 amounts will be based on 2025 income.
Does IRMAA apply to Medicare Advantage members?
Yes. IRMAA is tied to Part B and Part D, not to the type of plan. Medicare Advantage members still pay the Part B premium, including any income-related amount, and the Part D surcharge applies if the plan includes drug coverage.
Related Guides
Coverage pages for this topic: Medicare Advantage · Medicare Supplement · Medicare Part D. Other topics in the Learning Center: Health Insurance (ACA), Life Insurance, Final Expense, Annuities, Long-Term Care, Disability Insurance, Supplemental Health, Short-Term Medical, Travel Insurance.
Sources
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet)
- Medicare.gov — Medicare costs (2026)
- Medicare.gov — Costs for Medicare drug coverage
- SSA POMS HI 01120.001 — IRMAA and life-changing events (Form SSA-44)
Figures are labelled with the year they apply to and were checked against the official sources above on the review date. Rules and amounts change; confirm current figures with the agency that publishes them. This guide is general education, not individual advice.