In 2026, Medicare charges higher Part B and Part D premiums when your 2024 modified adjusted gross income exceeds $109,000 single or $218,000 joint. The Part B premium rises from $202.90 to as much as $689.90 a month. If retirement or another life-changing event cut your income, you can ask Social Security for a new determination.
What IRMAA is
The income-related monthly adjustment amount (IRMAA) is an extra charge added to Medicare Part B and Medicare prescription drug coverage (Part D) premiums when your income is above set thresholds. It is not a late-enrollment penalty, and it is not a separate plan premium. If you have only Part B or only drug coverage, the adjustment applies only to the coverage you have.
For most beneficiaries, the government pays about 75% of the total Part B cost and the beneficiary pays the remaining 25%. Higher-income beneficiaries pay a larger share — 35%, 50%, 65%, 80% or 85% of the total cost, depending on income, according to the Social Security Administration (SSA). The amounts in the tables below are monthly amounts per person, for 2026.
IRMAA does not set your Part A premium. Part A is premium-free for most people who worked and paid Medicare taxes long enough; people who must buy Part A pay $311 or $565 a month in 2026 depending on work history, as shown on Medicare.gov’s costs page.
Which income counts, and from which year
SSA uses your modified adjusted gross income (MAGI) — your adjusted gross income plus tax-exempt interest income. For 2026 premiums, SSA generally uses the federal tax return filed in 2025 for tax year 2024. That two-year lag is the part that surprises people most: a high-income year in 2024 sets 2026 premiums, even if your income has since fallen.
Two exceptions matter. If the IRS only provided SSA with your 2023 tax-year information, contact SSA, especially if you filed a 2024 return or did not need to file one for 2024. And if you amended your return and the amendment changes your MAGI, tell SSA with a copy of the amended return and your IRS acknowledgment receipt so it can correct or remove the adjustment.
The thresholds are $109,000 of MAGI for individual filers and $218,000 for joint filers. Above those levels, the surcharge applies in tiers, not gradually — which is why a small income change can matter a lot, as the examples below show.
2026 Part B premiums by income
The standard Part B premium for 2026 is $202.90 a month, with a $283 annual deductible. The table below shows the full 2026 Part B monthly premium for individual and joint filers, based on 2024 MAGI. The surcharge column is the author’s calculation (total premium minus the $202.90 standard premium).
| 2024 MAGI, individual return | 2024 MAGI, joint return | Part B premium per month, 2026 | IRMAA surcharge per month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $81.20 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $202.90 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $324.60 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $649.20 | $446.30 |
| $500,000 or above | $750,000 or above | $689.90 | $487.00 |
Married people who lived with their spouse during the year but filed a separate return are treated differently: there are only three tiers. At $109,000 or less of MAGI the premium is the standard $202.90; above $109,000 and less than $391,000 it is $649.20; and at $391,000 or above it is $689.90. If you are in this filing situation, check which tier applies before assuming the joint thresholds protect you.
2026 Part D surcharge
The Part D adjustment is added on top of your own plan’s premium — it does not replace it. SSA ties the amount to a base premium, not to your plan’s premium, so two people in the same income tier pay the same surcharge even if their plan premiums differ. If you receive Social Security payments, the Part D surcharge is deducted from them regardless of how you usually pay your plan premium; if the amount is larger than your payment, or you receive no monthly payment, you get a separate bill from another federal agency.
| 2024 MAGI, individual return | 2024 MAGI, joint return | Part D surcharge per month, 2026 |
|---|---|---|
| $109,000 or less | $218,000 or less | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $60.40 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $83.30 |
| $500,000 or above | $750,000 or above | $91.00 |
For married filing separately, the Part D surcharge is $83.30 a month above $109,000 and less than $391,000 of MAGI, and $91.00 a month at $391,000 or above. People with limited income and resources may instead qualify for Extra Help with drug costs; that program is separate from IRMAA and is worth checking before assuming the surcharge is unavoidable.
Worked examples: how the tiers bite
All examples below are the author’s calculations from the official 2026 tables above. They assume the person has Part B for the full year and, where Part D is mentioned, a plan premium stated in the example. Late-enrollment penalties, if any, are excluded — they would be added on top.
Example 1 — single, 2024 MAGI $120,000. This falls in the second tier: Part B is $284.10 a month, or $3,409.20 for the year, which is $974.40 more than the standard $2,434.80. With a $40 plan premium, Part D costs $54.50 a month ($40 + $14.50). The combined extra over the standard amounts is $95.70 a month.
Example 2 — the $1 cliff. A single filer with 2024 MAGI of $109,000 pays the standard $202.90. At $109,001, the same person pays $284.10 — $81.20 more every month, or $974.40 over the year, for $1 of additional MAGI. The tiers are cliffs, not a gradual slope, so income just over a threshold is charged at the full next-tier rate.
Example 3 — joint filers, MAGI $150,000. The same $150,000 that would put a single filer in the third tier ($405.80 a month) is below the $218,000 joint threshold, so a jointly filing couple pays the standard $202.90 each. Filing status, not just income, decides the tier — one reason a couple should check the joint table rather than applying the single-filer thresholds to each spouse’s income separately.
Example 4 — single, 2024 MAGI $250,000. This falls in the fifth tier: Part B is $649.20 a month, or $7,790.40 for the year — $5,355.60 more than the standard premium. The Part D surcharge adds $83.30 a month on top of the plan premium. If both spouses have Medicare, each spouse’s premium is set separately, so a couple at this income level can face the surcharge twice.
The practical lesson is timing: because the test uses one year’s MAGI, a single high-income year — a large capital gain, a lump-sum payout, a year of unusually high earnings — can raise premiums two years later even if later income is modest. That is also why the life-changing-event route below matters more than most people expect.
How to lower IRMAA after a life-changing event
If your income has gone down and the change moves you to a lower tier, you can ask SSA for a new determination. Qualifying events listed by SSA include marriage, divorce, the death of a spouse, stopping work or reducing work hours, losing income-producing property through a disaster or an event beyond your control, a scheduled cessation, termination or reorganization of an employer’s pension plan, and receiving an employer settlement because of a closure, bankruptcy or reorganization.
Use Form SSA-44, the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event form, and be ready to document both the event and the income reduction — for example, a death certificate, an employer letter about retirement, or a signed copy of the relevant tax return. You can submit the request through SSA’s request to lower an IRMAA page or by calling SSA at 1-800-772-1213. You do not need to file a formal appeal to request a new determination for one of these events.
A formal appeal is the route when you disagree with SSA’s decision itself — for example, if you believe the income figure is wrong and the life-event route does not apply. You can appeal online or with Form SSA-561-U2, Request for Reconsideration. If you disagree with the MAGI amount SSA received from the IRS, correct it with the IRS first; SSA cannot change IRS figures on its own. If SSA says you owe a Part D surcharge but you do not have drug coverage, call Medicare at 1-800-MEDICARE (1-800-633-4227) to correct the coverage record.
If the process feels confusing, your State Health Insurance Assistance Program (SHIP) offers free, local, one-on-one counseling and is not connected to any insurance company or plan. Find yours through the SHIP TA Center.
What IRMAA is not, and what to watch for 2027
IRMAA is recalculated each year from newer tax data, so a surcharge is not permanent — but without a qualifying life-changing event, a lower income year only helps when that year’s return becomes the basis for a later premium year. Do not expect a mid-year income drop alone to change the current year’s premium.
Also, the figures in this article are the 2026 figures. As of October 24, 2026, Medicare.gov’s costs page still lists only 2026 amounts, so 2027 IRMAA thresholds and premiums have not been announced yet. When they are, the same structure will apply — a new standard premium, new tiers based on 2025 MAGI — but the dollar amounts will change. Treat any 2027 IRMAA figure circulating now as unconfirmed.
If you are comparing plans during Medicare Open Enrollment (October 15 to December 7, 2026, for 2027 coverage), remember that changing plans does not change your IRMAA tier: the surcharge follows your income, not your plan. Compare total costs — plan premium plus any Part D surcharge, plus your Part B premium — rather than the plan premium alone.
Frequently asked questions
Does IRMAA apply if I have a Medicare Advantage plan? Yes. Medicare Advantage members must still have Part B and keep paying the Part B premium to stay in the plan, and the IRMAA surcharge applies to that premium. A plan’s advertised premium is not your total monthly cost if IRMAA applies.
Will my surcharge drop automatically next year if my income falls this year? Not immediately. SSA redetermines IRMAA each year from the tax return the IRS provides. A lower income year will be reflected when that return becomes the basis year, unless a qualifying life-changing event lets you request a new determination sooner.
Can I avoid IRMAA by delaying Part B? Delaying Part B does not avoid the adjustment and can add a separate late-enrollment penalty of 10% for each full 12-month period you were eligible but not enrolled, charged for as long as you have Part B. IRMAA and the late-enrollment penalty are different charges and can both apply.
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