If you have Medicare Part B and/or Medicare Part D prescription drug coverage, you could owe a monthly surcharge based on an income-related monthly adjustment amount (IRMAA). This surcharge is paid by Medicare beneficiaries for Parts B and D Medicare, in addition to the standard premiums, if their taxable income exceeds certain thresholds. For 2026, the IRMAA income brackets and surcharges increased by approximately 3% and 9% respectively.
The Medicare surcharge in 2026 will apply to beneficiaries with income exceeding $109,000 (for single filers and married filing separately) or $218,000 (for joint filers). For these beneficiaries, total monthly Part B premiums will range from $284.10 to $689.90. Part D surcharges will range from $14.50 to $91.00.
The IRMAA is calculated on a sliding scale with five income brackets, topping out at $500,000 for individual filing and $750,000 for married, filing jointly. These figures, except for the top bracket, are inflation-adjusted annually. For 2026, these inflation-adjusted brackets range from $109,000 to $205,000 for single tax filers and $218,000 to $410,000 for joint filers.
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IRMAA calculations have a two-year lag. Whether you pay an IRMAA in a given year depends on your tax returns from two years ago.
The IRMAA applies to all Medicare and Medicare Advantage beneficiaries whose earnings are high enough to make them eligible. The IRMAA is a cliff surcharge: just $1 over the limit will trigger surcharges for both Parts B and D. Income planning in the years leading up to Medicare eligibility can help beneficiaries avoid the surcharge.
Here's a look at the IRMAA and what it might cost you in 2026.
The IRMAA for 2026
IRMAA is a surcharge that some Medicare enrollees must pay in addition to regular Medicare Part B and Part D premiums. The surcharge is based on your Modified Adjusted Gross Income (MAGI) from two years ago. In other words, your 2026 IRMAA liability is based on your MAGI from 2024.
Medicare determines the 2026 IRMAA charge in the 4th quarter of 2025. That is why your IRMAA determination is based on 2024 filing status and income — it's the latest data point the Social Security Administration (SSA) can obtain from the IRS to determine your 2026 IRMAA liability.
The SSA determines who pays an IRMAA based on the income reported two years prior. The SSA looks at your 2024 tax returns to see if you must pay an IRMAA in 2026.
You can easily determine your 2026 Part B and Part D total premiums by adding the income-related monthly adjustment amount to the 2026 premium costs. For 2026, the Part B premium is $202.90, and the Part D is, on average, $46.50.
The 2026 IRMAA surcharge amounts for Part B range from $81.20 to $487.00.
The income brackets and inflation adjustments. The first four brackets of the IRMAA are indexed for inflation annually. However, the 5th bracket is currently frozen and can be indexed for inflation beginning in 2028.
The indexing is determined by how much the average CPI-U over the 12 months ending in the most recent August has increased compared to the average CPI-U for the previous 12-month period.
Income brackets- Single | Income brackets- Married, filing jointly | Part B IRMAA surcharge | Part D IRMAA surcharge |
Less than or equal to $109,000 | Less than or equal to $218,000 | $0 ($202.90 premium only) | $0.00 |
Greater than $109,000 and less than or equal to $137,000 | Greater than $218,000 and less than or equal to $274,000 | $81.20 ($284.10 total monthly premium) | $14.50 |
Greater than $137,000 and less than or equal to $171,000 | Greater than $274,000 and less than or equal to $342,000 | $202.90 ($405.80 total monthly premium) | $37.50 |
Greater than $171,000 and less than or equal to $205,000 | Greater than $342,000 and less than or equal to $410,000 | $324.60 ($527.50 total monthly premium) | $60.40 |
Greater than $205,000 and less than $500,000 | Greater than $410,000 and less than $750,000 | $446.30 ($649.20 total monthly premium) | $83.30 |
Greater than or equal to $500,000 | Greater than or equal to $750,000 | $487.00 ($689.90 total monthly premium) | $91.00 |
Couples that are liable for the IRMAA will pay a higher surcharge when filing separately. Why? The range of brackets and surcharges for married couples that file separately are narrower:
Income brackets- married filing separately | Part B IRMAA surcharge | Part D IRMAA surcharge |
|---|---|---|
Less than or equal to $109,00 | $0 ($202.90 premium only) | $0 |
Greater than $109,00 and less than $391,000 | $446.30 ($649.20 total monthly premium) | $83.30 |
Greater or equal to $, | $487.00 ($689.90 total monthly premium) | $91.00 |
Types of income that trigger the IRMAA
The modified adjusted gross income (MAGI) used to determine IRMAA is generally calculated by taking your Adjusted Gross Income (AGI) and adding back specific types of income that were excluded from AGI. In simple terms, for most people, the MAGI for IRMAA is the sum of their Adjusted Gross Income (AGI) from their tax return plus any tax-exempt interest income.
Adjusted Gross Income (AGI): This encompasses most sources of taxable income, such as:
- Wages and salaries
- Taxable portion of Social Security benefits
- Distributions from traditional IRAs, 401(k)s, and other tax-deferred retirement accounts (including Roth conversions)
- Interest (taxable) and dividends
- Capital gains
- Pension and annuity income
- Rental and royalty income
- Business income
Tax-exempt interest income. The IRMAA-specific MAGI is primarily your:
Adjusted Gross Income (Form 1040, Line 11) + your tax-exempt interest (Form 1040, Line 2a). That tax-exempt interest includes: interest from municipal bonds, tax-exempt dividends, and interest from U.S. Savings Bonds used for qualified higher education expenses would be added back to your AGI . This is a key "add-back" that often pushes retirees over an IRMAA threshold.
Income planning the best way to avoid the IRMAA
That is a crucial area of retirement planning. The core strategy for avoiding or reducing IRMAA is to lower your Modified Adjusted Gross Income (MAGI) in the relevant year, which is typically two years before the year you pay the premium.
Here are the most robust income planning tactics to manage your MAGI and mitigate IRMAA:
- Optimize your retirement account withdrawals (The "Roth Strategy") — Since withdrawals from traditional IRAs, 401(k)s, and RMDs (Required Minimum Distributions) are generally included in MAGI, while Qualified Roth withdrawals are not, strategic use of Roth accounts is the most powerful tool you have to reduce your MAGI and limit your exposure to the IRMAA.
Tactic | How | IRMAA Impact |
|---|---|---|
Strategic Roth conversions | Convert a portion of your Traditional IRA/401(k) to a Roth IRA before you start Medicare (or during years of low income in early retirement). | Increases MAGI now (in the year of conversion), but permanently lowers MAGI later (in retirement), minimizing future IRMAA risk. Spreading conversions over several years prevents a single, large conversion from pushing you into a high IRMAA bracket. |
Balance withdrawals | In retirement, balance your annual income draw by strategically pulling money from three buckets: 1) Taxable brokerage accounts (can generate capital gains), 2) Tax-deferred accounts (Traditional IRAs and 401(k)s), and 3) Tax-free accounts (Roth/HSA). | Use Roth and HSA funds to fill any gap needed to keep your MAGI below the next IRMAA threshold, giving you tax-free income instead of taxable income. |
Max out tax-deductible contributions (if working) | If you are still working, maximize pre-tax contributions to Traditional 401(k)s, 403(b)s, and Traditional IRAs. | Contributions are a direct adjustment to gross income, reducing your MAGI in the current year, which lowers your IRMAA calculation two years later. |
Here are three other ways to reduce your MAGI:
- Utilize Qualified Charitable Distributions (QCDs) to reduce the impact of RMDs.
- Manage investment income to avoid large capital gains spikes and harvest tax losses.
- Time and structure your income, by accelerating or deferring income, to limit unavoidable IRMAA liability, "take the IRMAA hit" for only one two-year period.
How to pay your IRMAA
Your monthly Medicare Part B and D IRMAA charges are deducted automatically from your Social Security check, with two exceptions: if you have opted to defer your Social Security benefits and do not receive a Social Security check, or if the amount of your Social Security check is not large enough to cover your IRMAA. In that case, you will receive a bill for the unpaid IRMAA balance from the Centers for Medicare & Medicaid Services (CMS).
IRMAA surcharges for Part B and Part D are paid separately. Part B IRMAA is automatically added to your monthly premium bill. The Part D IRMAA must be paid directly to Medicare, not your plan or employer.
It’s your responsibility to pay it even if your employer or a third party (e.g., retirement system) pays your Part D plan premiums. You’ll get a bill each month from Medicare for your Part D IRMAA, and you can pay it the same way you pay your Part B premiums.
You have three ways to pay your Medicare IRMAAs online — either through your MyMedicare account, your bank’s bill pay service or you can automate the process by using Medicare Easy Pay. I recommend using a MyMedicare account. It is safe, secure, and there is no fee to make a payment. You’ll need to know your Medicare number and your Medicare Part A start date to create your account. You can find both on your Medicare card.
Lastly, you can send your payment by mail to Medicare Premium Collection Center, PO Box 790355, St. Louis, MO 63179-0355.
Plan to avoid the IRMAA
You should be mindful of the risk of a one-time spike in income that could trigger the IRMAA, such as the proceeds from a home sale or converting your traditional IRA to a Roth IRA. To avoid this risk, be sure to properly time a Roth conversion; you can then avoid the IRMAA when you take tax-free distributions. Learn more about strategies, such as how to lower taxes on required minimum distributions that could otherwise trigger the surcharge.
If your income suddenly dropped due to a major life event or change of circumstances, you do not have to wait two years for the IRMAA to adjust. You can appeal the surcharge with SSA using Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event).
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