Medicare IRMAA 2026 — income brackets & surcharges.
If your income from two tax years ago exceeds certain thresholds, Medicare adds an Income-Related Monthly Adjustment Amount (IRMAA) to your Part B and Part D premiums. About 8% of Medicare beneficiaries pay it. Below are 2026 brackets and how to appeal.
2026 IRMAA brackets — full table
2026 IRMAA is based on your 2024 tax return MAGI (Modified Adjusted Gross Income = AGI plus tax-exempt interest).
| 2024 MAGI (Single) | 2024 MAGI (Married Filing Jointly) | Part B premium | Part D surcharge | Total monthly |
|---|---|---|---|---|
| $106,000 or less | $212,000 or less | $185.00 | $0 | $185.00 |
| $106,001 – $133,000 | $212,001 – $266,000 | $259.00 (+$74.00) | +$13.70 | $272.70 |
| $133,001 – $167,000 | $266,001 – $334,000 | $370.10 (+$185.10) | +$35.30 | $405.40 |
| $167,001 – $200,000 | $334,001 – $400,000 | $480.90 (+$295.90) | +$57.00 | $537.90 |
| $200,001 – $500,000 | $400,001 – $750,000 | $591.80 (+$406.80) | +$78.50 | $670.30 |
| Over $500,000 | Over $750,000 | $628.20 (+$443.20) | +$85.80 | $714.00 |
Standard Part B premium in 2026 is $185.00. The surcharge is added on top. Part D surcharge is added on top of whatever your Part D plan's regular premium is — and is paid directly to Medicare, not to your Part D carrier.
How IRMAA actually works
1. The look-back is two years
2026 IRMAA = based on your 2024 tax return. 2027 IRMAA = based on your 2025 tax return. The IRS shares your AGI with Social Security each year, and SSA recalculates IRMAA annually each November.
2. Both spouses pay separately
If you and your spouse are both on Medicare and your joint MAGI puts you in the $250K bracket, both of you pay the surcharge. The surcharge is per-person, not per-household.
3. The "cliff" matters
IRMAA is a cliff system, not a phase-in. If you're a single filer at $106,000 MAGI, you pay nothing extra. At $106,001, you pay $87.70/month extra (Part B + Part D). One dollar over a threshold adds $1,053/year in surcharges — for two years (since the look-back is 2 years).
4. Roth conversions can trigger it
Roth conversions add to MAGI in the year converted. A $50,000 conversion in 2024 raises your 2024 MAGI by $50,000 — potentially pushing you into a higher 2026 IRMAA bracket. Plan large conversions before Medicare eligibility (age 63 or earlier) when possible.
5. Capital gains can trigger it
Selling a long-held investment, selling a home over the $250K/$500K exclusion, or receiving a one-time large pension lump sum can all push your MAGI above an IRMAA threshold for one year. The good news: it's only one year of higher premiums.
How to appeal IRMAA — Form SSA-44
If you've had a "life-changing event" (LCE) that reduced your income after the tax year used for IRMAA, you can appeal using Form SSA-44.
Qualifying life-changing events
- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage (retirement)
- Work reduction (going part-time)
- Loss of income-producing property (e.g., rental property destroyed)
- Loss or reduction of pension income
- Employer settlement payment due to employer bankruptcy
Not qualifying: Roth conversions, capital gains, lottery winnings, gifting (these are not "life-changing events" by SSA's definition).
How to file
- Download Form SSA-44 from ssa.gov
- Provide documentation of the LCE (marriage certificate, death certificate, retirement letter, etc.)
- Provide your projected current-year MAGI estimate (with proof if possible)
- Submit by mail or in-person at your local SSA office. SSA typically responds in 30-60 days.
If approved, your IRMAA is recalculated based on your projected current-year income. If your actual income later differs, SSA will adjust again at the next annual recalculation.
IRMAA tax-planning strategies
Most IRMAA exposure can be reduced or avoided with planning before age 63 (since IRMAA looks back 2 years from your Medicare-eligible year). Common strategies:
- Front-load Roth conversions in years before the IRMAA look-back window starts.
- Spread capital gains across multiple years to stay under bracket thresholds.
- Use Qualified Charitable Distributions (QCDs) from IRAs at age 70.5+ — counts toward RMD without raising MAGI.
- Tax-loss harvest in high-income years to offset gains.
- Time large home sales to fall outside the IRMAA look-back when possible.
- Coordinate with your CPA or financial advisor — IRMAA planning is a tax issue, not just a Medicare issue.
Have IRMAA questions? We can help.
A licensed advisor reviews your IRMAA notice, helps you understand which bracket you're in, and walks you through Form SSA-44 if you have a qualifying life-changing event. Free, no obligation.
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