IRMAA in 2026: Medicare Premium Surcharges Explained
If your income exceeds certain thresholds, you'll pay more for Medicare Part B and Part D. Here's how IRMAA works and what you can do about it.
IRMAA — the Income-Related Monthly Adjustment Amount — is a surcharge that higher-income Medicare beneficiaries pay on top of the standard Part B and Part D premiums. It's based on your modified adjusted gross income (MAGI) from your tax return two years prior. For 2026, that means your 2024 income determines your surcharge.
How IRMAA Brackets Work
The Social Security Administration reviews your income each year and assigns you to an IRMAA bracket. The standard Part B premium for 2026 is $202.90 per month. If your MAGI exceeds the threshold — currently $109,000 for individual filers or $218,000 for joint filers — you'll pay an additional amount ranging from $81.20 to $487.00 per month, depending on your income level.
For a detailed breakdown of each bracket, see our complete 2026 IRMAA income brackets guide.
Common IRMAA Triggers
Many beneficiaries are surprised by IRMAA surcharges because they don't realize what counts as income. Capital gains from selling a home, Roth IRA conversions, required minimum distributions, and even tax-free municipal bond interest can affect your MAGI. Our article on hidden IRMAA triggers explains the most common surprises.
IRMAA Appeals
If your income has changed due to a life-changing event — such as retirement, divorce, or death of a spouse — you may be able to appeal your IRMAA determination. The SSA accepts appeals for specific qualifying events with proper documentation. Use our IRMAA Appeal guide to understand the process.
Planning Ahead
Because IRMAA uses a two-year lookback, the most effective planning happens before you enroll in Medicare. Strategic income management — including careful timing of Roth conversions and capital gains — can significantly reduce lifetime IRMAA costs. Check your estimated surcharges with our IRMAA Calculator.