IRMAA, the Income-Related Monthly Adjustment Amount, is an extra charge on top of your Medicare Part B and Part D premiums when your income is above a set threshold. In 2026 it starts when your 2024 modified adjusted gross income is above $109,000 as a single filer or $218,000 as a married couple filing jointly. If your income has dropped since then, because you retired, for example, you can ask Social Security to use a lower figure.
This guide shows the 2026 brackets, explains why Social Security looks at a tax year from two years back, and walks through the ways to reduce or remove a surcharge.
TL;DR
- IRMAA is a surcharge on Part B and Part D, not a separate program. About 8% of enrollees pay it, which means roughly 92% do not.
- For 2026, the Part B surcharge runs from $81.20 to $487.00 a month and the Part D surcharge from $14.50 to $91.00 a month, depending on your income tier.
- The 2026 amount is based on your 2024 tax return, so a recent retirement or other income drop can leave you paying for income you no longer have.
- If a qualifying life-changing event lowered your income, you can request a reduction with Form SSA-44. You do not have to wait for a formal appeal.
Table of Contents
- What IRMAA is and who pays it
- 2026 IRMAA brackets
- Why Social Security uses income from two years ago
- How to lower or remove your IRMAA
- Planning ahead: income decisions before and after 65
- Does IRMAA change which plan you should choose?
- Our perspective
- Get help with Medicare costs
- FAQ
- Sources
What IRMAA is and who pays it
Most people pay the standard Part B premium, which is $202.90 a month in 2026. If your income is high enough, Social Security adds a surcharge to that Part B premium. It can also add a surcharge to your Part D prescription drug coverage.
Two details trip people up:
- It is not paid to your insurance company. The Part D surcharge is billed by the government, not by your drug plan. Your plan premium stays what it is, and IRMAA is added on top.
- It applies to Part B and Part D only. Part A is premium-free for most people, and a Medicare Advantage plan's own premium is separate. If you have a Medicare Advantage plan that includes drug coverage, the Part D surcharge still applies.
The surcharge is charged per person. In a married couple where both spouses are on Medicare, each one pays it, so the household cost doubles.
2026 IRMAA brackets
The thresholds below apply to 2026 premiums and use your 2024 income. The Part B figures are the total monthly premium, including the standard amount. These match the CMS 2026 premiums and deductibles fact sheet, which lists the standard premium, the $689.90 top Part B total, and the thresholds starting at $109,000 and $218,000.
| 2024 income, single | 2024 income, married filing jointly | Total Part B premium per month | Part D surcharge per month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 to $137,000 | Above $218,000 to $274,000 | $284.10 | $14.50 |
| Above $137,000 to $171,000 | Above $274,000 to $342,000 | $405.80 | $37.50 |
| Above $171,000 to $205,000 | Above $342,000 to $410,000 | $527.50 | $60.40 |
| Above $205,000 to under $500,000 | Above $410,000 to under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Married people who file separately and lived with their spouse at any point in the year have a much tighter scale: above $109,000 they move straight to the $649.20 tier, and at $391,000 or more they pay the top $689.90 tier.
The cliff-like design matters. These are tiers, not a sliding scale. Being $1 over a threshold moves you into the next tier for the whole year, and the step up in the first tier is $81.20 a month for Part B plus $14.50 for Part D, about $1,140 a year for one person.
What the surcharge costs over a year
The published surcharge range is $81.20 to $487.00 for Part B and $14.50 to $91.00 for Part D. Here is how that adds up for one person at the lowest and highest tiers:
| Tier | Part B surcharge per month | Part D surcharge per month | Combined per year |
|---|---|---|---|
| First tier | $81.20 | $14.50 | $1,143.60 |
| Top tier | $487.00 | $91.00 | $6,936.00 |
The Part B surcharge is the standard premium subtracted from the tier's total ($284.10 minus $202.90 is $81.20). A couple in the first tier, both on Medicare, would pay $2,287.20 a year combined.
Why Social Security uses income from two years ago
The agency needs a complete tax return to measure your income, and the most recent one it can reliably get from the IRS is usually from two years earlier. So 2026 premiums rest on your 2024 return. By the same logic, your 2027 premiums will rest on your 2025 return. The 2027 brackets are normally announced in the fall, so check the CMS newsroom before you plan around any specific figure.
The income measure is modified adjusted gross income, or MAGI. It starts with the adjusted gross income on your return and adds back certain items such as tax-exempt interest. That is why people with modest taxable income can still land in a bracket: a large capital gain from selling a home or a business, a Roth conversion, or a big IRA withdrawal in a single year all increase MAGI.
The lookback creates what the Social Security guidance describes as a gap between your current reality and the tax data on file. The surcharge is a determination based on a past return, not a permanent tax, and that is exactly why it can be changed.
A common example
Say you worked full time through 2024 and earned $160,000 as a single filer. You retired in 2025 and now live on Social Security and a modest pension. Your 2026 premiums still use the $160,000, which puts you in the third tier at $405.80 for Part B, plus the Part D surcharge. Your actual income is far lower, and retirement is a recognized reason to ask for a change.
How to lower or remove your IRMAA
There are two different situations, and the fix depends on which one you are in. Social Security staff suggest that the first step is to clarify what the determination is based on: outdated tax information, an error, or a genuine life-changing event.
Option 1: A life-changing event reduced your income
You can ask Social Security to use a more recent, lower income estimate. The qualifying events listed on Form SSA-44 are:
- Death of a spouse
- Marriage
- Divorce or annulment
- Work reduction or stoppage
- Loss of income-producing property
- Loss of pension income
- Receipt of an employer settlement payment
The Social Security page on lowering IRMAA explains the request process. In practice, the steps are:
- Download and complete Form SSA-44, stating which event happened and the date.
- Include your estimate of your income for the current and following year.
- Attach evidence, such as a retirement letter, a death certificate, a divorce decree, or a pay stub showing reduced hours.
- Submit it to Social Security and keep a copy.
This is not a formal appeal. Per Social Security's own operating guidance, the request is treated as a new initial determination, which is often faster. You can pursue it alongside a formal appeal if you want to.
One caution: a reduction is based on your estimated income for the year, so be realistic. Include everything that counts, such as required distributions from retirement accounts, and review the following year again, because the lower tier can change if your income goes back up.
Option 2: The tax data is wrong or out of date
Sometimes there is no life event, but the number is simply wrong. The guidance describes several situations:
- Amended return. If you filed an amended return that lowers your MAGI, you need to provide both the amended return and an IRS letter acknowledging receipt. If you do not have the letter, you can submit an IRS transcript of the amended return instead.
- Older data was used. If Social Security used a return from three years back, you can request a new determination if you have the return from two years back, or can show you were not required to file one for that year.
In these cases, you may need to contact the IRS to correct the record first, before Social Security can act.
What to do if you disagree with the decision
If Social Security turns down your request, or you think it miscalculated, the notice you receive explains your appeal rights and deadlines. Read the deadline on the notice itself and act on it promptly, and keep copies of every document you send.
Planning ahead: income decisions before and after 65
Because of the two-year lookback, income decisions at 63 affect premiums at 65. A few things to consider with your tax professional:
- Big one-time income. Selling a business, a second home or a large stock position can push a single year into a higher tier. If you can spread it over more than one tax year, you may stay under a threshold.
- Roth conversions. Converting pre-tax retirement money adds to MAGI in the year of the conversion. The tax savings later may be worth it, but the IRMAA effect two years on should be part of the math.
- The first year on Medicare. If you were still working at 63 and 64, your first Medicare premiums may reflect a high-income year even though you retired by 65. That is a classic case for Form SSA-44.
These are planning questions that touch your tax return, so a CPA or tax preparer should confirm the numbers. What we can do is show you how the Medicare side works so the right questions get asked.
Does IRMAA change which plan you should choose?
It does not change which plans are available to you, but it changes the cost picture. Here is how it plays into common choices:
| Coverage | Does IRMAA apply? | What to check |
|---|---|---|
| Original Medicare Part B | Yes | Your total monthly premium for your tier |
| Part D drug plan | Yes, billed by the government | Plan premium plus the surcharge |
| Medicare Advantage with drug coverage | Yes, for Part B and the drug part | Plan premium, plus Part B and Part D surcharges |
| Medicare Supplement (Medigap) | No surcharge on the policy itself | Your Part B surcharge still applies |
The lesson: a plan with a $0 premium is not a $0 cost if you are in an IRMAA tier, because you still pay the Part B premium and, if applicable, the surcharge. When comparing, add up the full monthly picture. Our Michigan Medicare guide covers Advantage, Part D and Medigap side by side, and our post on Medicare at 65 and Part D penalties explains how to avoid a drug-coverage penalty, which is a separate charge from IRMAA.
It also helps to know that surcharges are the exception. Federal subsidies cover about 75% of the Part B cost for most enrollees, and original Medicare still leaves gaps: for example, the 2026 inpatient hospital deductible is $1,736 per benefit period. Budget for those costs next to any IRMAA.
Our perspective
We see the same pattern every fall. Someone retires at 64 or 65, signs up for Medicare, and then a letter arrives from Social Security with a premium far above what they expected. They assume it is final. It usually is not.
The important thing is to spot it early. The letter arrives with a deadline-driven process, and the people who do best are those who gather their retirement paperwork before enrolling, not after. If you know you are retiring in the next year or two, ask us before you pick a plan. We work with several carriers, so the advice on coverage is not tied to one company, and our help comes at no cost to you.
We do not prepare tax returns, and we will not tell you how to structure your income. What we will do is explain how Medicare's rules treat your situation, point you to the right form, and make sure your plan choice makes sense with the premium you will actually pay.
— Brian
Get help with Medicare costs
If you are turning 65, retiring, or just opened an IRMAA letter, we can help you sort out what you owe and which coverage fits. Start with our Medicare page for people turning 65, or see everything we handle on our services page. If you are weighing a plan change during the fall enrollment window, our Medicare open enrollment checklist lists six checks to run first.
Have questions? We have answers! Contact us to schedule a no-obligation meeting.
- Call or text 616-221-4616
- Meet on your terms: In Person • Phone • Virtual
FAQ
What percent of Medicare enrollees pay IRMAA?
About 8% of Part B and Part D enrollees pay an income-related surcharge, according to CMS. That means the large majority pay only the standard premium. If your income is below $109,000 as a single filer or $218,000 as a joint filer, you are in that group for 2026.
Can I appeal my IRMAA?
Yes, and if your income dropped because of a qualifying event you can start with a request for a new determination using Form SSA-44 rather than a formal appeal. If you think Social Security used wrong or outdated tax data, you can request a new decision with the correct return. The notice you receive describes your appeal rights and time limits.
Does IRMAA apply to Medicare Advantage?
Yes. You still pay the Part B premium, including any surcharge, even when you are in a Medicare Advantage plan. If your plan includes prescription drug coverage, the Part D surcharge applies as well, and it is billed by the government, not by the plan.
Will my IRMAA go away when I retire?
Not automatically. Social Security bases your premium on an older tax return, so it may keep charging the higher amount until the data catches up. Retirement counts as a work stoppage or reduction on Form SSA-44, so file the request with proof of your retirement to have your premium reassessed.
Sources
- CMS: 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov: 2026 Medicare costs (PDF)
- Medicare.gov: Medicare costs
- SSA: Request to lower an IRMAA
- SSA: Form SSA-44, Life-Changing Event
- SSA POMS HI 01120.001: New initial determinations on IRMAA