The short answer
In 2026, IRMAA applies when your 2024 income was above $109,000 (single) or $218,000 (married filing jointly). It raises the Part B premium from $202.90 to between $284.10 and $689.90 a month and adds $14.50 to $91.00 to Part D, per person. The brackets are cliffs, and you can appeal with form SSA-44 after a life-changing event.
- Threshold: above $109,000 single or $218,000 joint, based on your 2024 tax return for 2026.
- Part B: $284.10 to $689.90 a month per person, versus the $202.90 standard premium.
- Part D: an extra $14.50 to $91.00 a month per person, paid to Medicare.
- Appeal: form SSA-44 after marriage, divorce, a spouse's death, retirement or another life-changing event.
Applies to anyone enrolled in Medicare Part B or Part D, including Medicare Advantage members, whose income two years earlier was above the IRMAA threshold. Tax planning choices should be reviewed with a tax professional.
What is IRMAA?
IRMAA, the income-related monthly adjustment amount, is an extra charge on Medicare Part B and Part D premiums for people with higher incomes. In 2026 it starts when your 2024 income was above $109,000 for a single filer or $218,000 for a married couple filing jointly. Everyone below those lines pays the standard Part B premium of $202.90 a month.
IRMAA is set by Social Security, not by your plan or your agent, and it applies whether you have Original Medicare, a Medicare Advantage plan or a standalone Part D plan.
How is IRMAA calculated?
Social Security uses your modified adjusted gross income (MAGI) from your federal tax return two years earlier. MAGI for IRMAA is your adjusted gross income plus any tax-exempt interest. So 2026 premiums are based on your 2024 return, and 2027 premiums will be based on your 2025 return.
The brackets are cliffs, not a slope. Going one dollar over a threshold moves you into the next tier for the full year. That is why two retirees with almost the same income can pay very different premiums.
2026 IRMAA brackets for Part B and Part D
These are the 2026 figures CMS published on November 14, 2025. Amounts are per person, per month.
| 2024 income, single or head of household | 2024 income, married filing jointly | Part B premium | Part D IRMAA | Extra cost per year, per person |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 | $1,148.40 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 | $2,884.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 | $4,620.00 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | $83.30 | $6,355.20 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 | $6,936.00 |
If you are married, file separately and lived with your spouse at any time during the year, there are only two surcharge tiers: above $109,000 you pay $649.20 for Part B plus $83.30 for Part D, and at $391,000 or more you pay $689.90 plus $91.00. The Part D amount is added to whatever your drug plan charges.
Calculate your IRMAA
Enter your filing status and income to see your premiums, how far you are from the next bracket, and whether a life-changing event could let you appeal. You can copy the results, share a link or print a one-page summary.
IRMAA calculator
What will you pay for Medicare Part B and Part D?
Adjusted gross income (Form 1040, line 11) plus tax-exempt interest (line 2a).
Did your income drop? Check if you can appeal
IRMAA calculator by Smart Insurance Agents. Estimates only; Social Security makes the final determination.
What will the 2027 IRMAA brackets be?
CMS publishes next year’s Part B premium and IRMAA brackets in the fall, usually in November, and the 2026 figures came out on November 14, 2025. The 2027 brackets will be based on your 2025 income. The income thresholds are adjusted for inflation each year, except the top tier ($500,000 single and $750,000 joint), which is fixed.
We update this page and the calculator as soon as CMS releases the 2027 figures, so you can bookmark either one.
How the IRMAA cliff works: a worked example
Take a single filer whose 2024 income was exactly $109,000. In 2026 they pay the standard $202.90 a month for Part B and no Part D surcharge. A neighbor with $109,001 pays $284.10 for Part B plus $14.50 for Part D, which comes to $1,148.40 more for the year.
For a married couple filing jointly who are both on Medicare, the surcharge applies to each spouse. Crossing $218,000 costs the couple $2,296.80 for the year, and moving from the first tier to the second costs another $3,472.80. Knowing where the edges are is most of the planning.
How can you lower or avoid IRMAA?
Because IRMAA follows your tax return, the main lever is timing income in the years that count. People close to a threshold often look at a few moves with their tax professional:
- Roth conversions: spreading conversions over several years, or finishing them before the two-year lookback begins.
- Capital gains: timing the sale of appreciated investments or real estate.
- Qualified charitable distributions: after age 70½, giving from an IRA directly to charity keeps that amount out of income.
- Tax-exempt interest: it counts toward MAGI for IRMAA even though it is not taxed, so it does not help here.
These choices affect your taxes, not just your Medicare premiums, so run the numbers with a CPA or financial advisor before acting.
How do you appeal IRMAA with form SSA-44?
If your income has dropped since the tax year Social Security used, you can ask it to use a more recent year. This works when the drop comes from a life-changing event:
- Marriage, divorce or annulment, or the death of your spouse
- Work stoppage or reduced work hours, including retirement
- Loss of income-producing property through no fault of your own
- Loss or reduction of pension income, or an employer settlement payment
File form SSA-44 with Social Security, list the event, and include proof, such as a retirement letter or a death certificate, along with your tax return or an estimate for the lower year. If Social Security used the wrong tax information, for example before an amended return was processed, you can ask for a new determination for that reason as well.
How is IRMAA billed and paid?
If you receive Social Security benefits, the Part B and Part D IRMAA amounts are usually deducted from your monthly check. If not, Medicare bills you directly. The Part D IRMAA is always paid to Medicare, not to your drug plan, even if you have a Medicare Advantage plan or your former employer pays your plan premium.
IRMAA does not change what you pay for a Medigap plan. It is also a qualified expense for a Health Savings Account after 65, so money saved in an HSA can pay it tax-free. Our guide to HSAs and Medicare explains how.
Can agents and advisors use this calculator?
Yes. The IRMAA calculator is open to anyone to use with clients, and agents, advisors and planners can add it to their own websites with a short embed code. It updates automatically each year when CMS publishes new figures. If you are also planning around work and Medicare timing, see working past 65 and Medicare.
Questions people ask
What are the 2026 IRMAA brackets?
For single filers, IRMAA starts above $109,000 of 2024 income, with tiers at $137,000, $171,000, $205,000 and $500,000. For joint filers, it starts above $218,000, with tiers at $274,000, $342,000, $410,000 and $750,000. The Part B premium ranges from $284.10 to $689.90.
What year's income is used for 2026 IRMAA?
Your 2024 federal tax return. Social Security generally uses the return from two years before the premium year, and a more recent year only if you qualify for a life-changing event appeal.
Is IRMAA per person or per couple?
Per person. If you file jointly and both spouses have Medicare, each of you pays the surcharge, so the household cost is doubled.
What counts as income for IRMAA?
Modified adjusted gross income: your adjusted gross income plus tax-exempt interest. Roth conversions, capital gains, IRA withdrawals and required minimum distributions all raise it.
When will the 2027 IRMAA brackets be released?
CMS usually announces next year's Part B premium and IRMAA amounts in the fall, often in November. The 2026 figures were released on November 14, 2025. This page updates when the 2027 figures come out.
Does IRMAA apply to Medicare Advantage?
Yes. Medicare Advantage members still pay the Part B premium, including any IRMAA, and the Part D IRMAA applies if the plan includes drug coverage.
Does IRMAA affect Medigap premiums?
No. Medigap premiums are set by the insurance company. IRMAA only adds to the Part B premium and to Part D.
How do I appeal IRMAA?
If a life-changing event such as retirement, divorce or the death of a spouse lowered your income, file form SSA-44 with Social Security and include proof of the event and your lower income. You can also request a new determination if the tax information used was wrong.
How long does IRMAA last?
It is recalculated every year. If your income drops below the threshold in a later tax year, the surcharge goes away two years later without any action on your part.
Can I pay IRMAA from my HSA?
Yes, once you are 65. IRMAA is part of your Part B and Part D premiums, which are qualified expenses for a Health Savings Account.
Why is married filing separately so expensive for IRMAA?
If you lived with your spouse during the year and file separately, there are only two surcharge tiers, and the first starts at $649.20 a month for Part B once income passes $109,000.
How does Social Security collect IRMAA?
If you get Social Security benefits, the amounts are usually withheld from your check. Otherwise Medicare sends you a bill. The Part D portion is paid to Medicare, not your drug plan.
Sources
- CMS, 2026 Medicare Parts A and B Premiums and Deductibles, November 14, 2025
- Electronic Code of Federal Regulations, 20 CFR Part 418: Medicare Subsidies, accessed September 27, 2026
- Social Security Administration, Form SSA-44: Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event, accessed September 27, 2026
- Medicare.gov, Part B costs, accessed September 27, 2026
Close to an IRMAA bracket?
Send us your filing status and the income you expect for the next two years, and a licensed advisor will show where the brackets fall and how your Medicare plan choices fit, within one business day. No obligation.
Review my IRMAACall or text (773) 657-9140Smart Insurance Agents LLC is an independent, licensed insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program for information on all of your options. Content is for general information and is not a guarantee of coverage or rates; figures are subject to change by CMS and carriers.