2026 IRMAA Income Brackets & Surcharges

What Counts Toward MAGI — and Ways to Lower It

Social Security usually mails IRMAA determination notices in November or December, before the new premium year starts. Your Part B surcharge is normally taken out of your Social Security benefit along with the standard premium. The Part D surcharge is paid to Medicare, not to your drug plan — it's also taken from your benefit, or billed to you if you don't receive benefits yet.

Planning approaches that can lower MAGI

• Roth conversions in lower-income years. Converting before Medicare starts — or in a year when income dips — adds income now, but qualified Roth withdrawals later don't count toward MAGI. Remember that the conversion year itself counts, two years later.
• Qualified charitable distributions. At age 70½ or older, you can send money directly from an IRA to a charity (up to the annual IRS limit). It can count toward your required minimum distribution without adding to MAGI.
• Withdrawal order. Drawing from taxable savings or Roth accounts before traditional IRA or 401(k) money can help keep income under a bracket line.
• Harvesting capital losses. Selling investments at a loss in a taxable account can offset gains and lower AGI for the year.
• Deductions in the years before Medicare. Deductible traditional IRA contributions (which require earned income) and HSA contributions lower AGI. HSA contributions have to stop once you enroll in Medicare, so this mainly helps in the working years at 63 and 64 that set your first IRMAA.

These choices have tax effects beyond Medicare, so it's worth running the numbers with a CPA or financial planner first.

One-Time Income Spikes, Couples, and Checking Your Notice

How 2026 compares with 2025

The first IRMAA threshold rose from $106,000 (single) and $212,000 (married filing jointly) in 2025 to $109,000 and $218,000 in 2026, and the standard Part B premium rose from $185.00 to $202.90. The lower thresholds are adjusted for inflation each year. The top thresholds — $500,000 single and $750,000 joint — are fixed in law and don't adjust until 2028.

If you're married but file separately

Married people who lived with their spouse at any point in the year and file separately use a much shorter scale for 2026. Income up to $109,000 pays the standard premium. Income above $109,000 and below $391,000 pays $649.20 a month for Part B plus $83.30 for Part D. Income of $391,000 or more pays $689.90 for Part B plus $91.00 for Part D.

One-time income spikes

IRMAA looks at one year of income at a time, so a single unusual year can raise your premiums two years later even if your income goes back to normal. Common causes are Roth conversions, selling a home or investment property at a large gain, big IRA or 401(k) withdrawals (including required minimum distributions), severance or lump-sum pension payments, and a final year of full salary before retiring.

Couples can pay twice

For married couples filing jointly, the bracket is set by your combined income, and each spouse on Medicare pays their own surcharge. If both of you are enrolled, the household cost is doubled.

Check the tax year on your notice

Your IRMAA letter shows which tax return Social Security used. If your 2024 return wasn't available yet, Social Security may have used your 2023 return instead. If that older return overstates your income, or if you filed an amended return, you can ask Social Security to use the correct, more recent figures.

Don't let a Part D surcharge go unpaid

If you're billed directly rather than having it taken from your benefit, pay the Part D surcharge on time. Leaving it unpaid can end your Part D drug coverage.