Medicare IRMAA 2026: Brackets, Part B and D Surcharges
Medicare IRMAA 2026: Income Brackets, Part B and Part D Surcharges Explained
What the income-related monthly adjustment amount is, which income counts, how a single dollar can move you up a bracket, and how to ask for a new decision, all from CMS and SSA sources.
IRMAA is an extra monthly charge added to Medicare Part B and Part D premiums for people whose income is above a set level. For 2026 the standard Part B premium is $202.90 a month, and the first surcharge applies when modified adjusted gross income (MAGI) is above $109,000 for a single filer or $218,000 for a joint return. According to CMS, the total Part B premium then rises in five steps, up to $689.90 a month at $500,000 (single) or $750,000 (joint). Social Security generally uses your tax return from two years earlier, so 2026 premiums are based mostly on 2024 income. The brackets are cliffs, not a gradual slope: one dollar over a threshold moves the whole year into the higher bracket. The 2027 premiums have not been announced yet.
Most people planning for retirement budget for the standard Medicare premium and stop there. But Medicare has an income test that quietly adds hundreds of dollars a month for higher earners, and it looks back at a tax return you filed years before the premium starts. Understanding how it works is useful whether you are already on Medicare, approaching 65, or deciding how to time income such as withdrawals or asset sales. This guide uses the official CMS and Social Security Administration (SSA) figures for 2026 and a calculator so you can see where a given income lands.
1. What IRMAA Is
IRMAA stands for income-related monthly adjustment amount. It is a surcharge added to two Medicare premiums: Part B (outpatient and medical services) and Part D (prescription drug coverage). Part A usually has no premium for people with enough work credits, so IRMAA does not apply there in the usual case.
Three features define it:
- It is per person. On a joint return, each spouse enrolled in Medicare pays the surcharge.
- It is bracketed. Income is sorted into one of six tiers (the standard one plus five surcharge tiers), each with a fixed dollar surcharge.
- It is notified by SSA. According to SSA, you receive a letter with your premium amount and the reason for the determination.
2. Which Income Counts
The test uses modified adjusted gross income (MAGI). SSA's handbook defines it as the adjusted gross income on page 1 of Form 1040 plus tax-exempt interest reported on line 8b. That means municipal bond interest, which is not taxed, still counts here.
It also sets the timing. SSA generally uses the return from two years before the premium year, and no more than three years prior. For 2026 premiums, SSA says it generally uses 2024 income, from a return filed in 2025, and sometimes 2023 data. In practice this means a one-time income spike, such as a large asset sale at 63, can raise premiums at 65, long after the income has gone.
3. The 2026 Part B Table
The numbers below come from the CMS 2026 premiums and deductibles fact sheet. The standard Part B premium is $202.90 a month and the annual Part B deductible is $283.
| Individual MAGI | Joint MAGI | Surcharge (monthly) | Total Part B (monthly) |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $202.90 |
| Above $109,000 to $137,000 | Above $218,000 to $274,000 | $81.20 | $284.10 |
| Above $137,000 to $171,000 | Above $274,000 to $342,000 | $202.90 | $405.80 |
| Above $171,000 to $205,000 | Above $342,000 to $410,000 | $324.60 | $527.50 |
| Above $205,000 to below $500,000 | Above $410,000 to below $750,000 | $446.30 | $649.20 |
| $500,000 or more | $750,000 or more | $487.00 | $689.90 |
Married people who file separately and lived with their spouse at any time during the year face a compressed schedule, according to CMS: $202.90 at $109,000 or less, $649.20 above $109,000 and below $391,000, and $689.90 at $391,000 or more. That is why filing separately is rarely a low-premium choice for a Medicare couple.
To see the yearly size of each step, multiply by twelve: the surcharge alone is $974.40 a year in the first bracket, $2,434.80 in the second, $3,895.20 in the third, $5,355.60 in the fourth and $5,844.00 in the fifth. The standard premium is $2,434.80 a year, so the top bracket roughly triples the Part B cost (689.90 ÷ 202.90 = 3.4).
4. The 2026 Part D Table
Part D works differently. Your drug plan sets its own premium, and IRMAA adds a fixed amount on top, tied to a national base premium rather than your plan's price. SSA's 2026 chart shows the monthly add-on for each bracket:
| Bracket (same income tiers as Part B) | Part D add-on (monthly) | Per year |
|---|---|---|
| 1 (standard) | $0.00 | $0 |
| 2 | $14.50 | $174.00 |
| 3 | $37.50 | $450.00 |
| 4 | $60.40 | $724.80 |
| 5 | $83.30 | $999.60 |
| 6 | $91.00 | $1,092.00 |
These add-ons apply to people with Part D or Medicare Advantage drug coverage. A person without drug coverage does not pay the Part D amount. Source: SSA, Medicare premiums.
5. Medicare IRMAA Calculator
Pick your filing status, enter your modified adjusted gross income, and the calculator shows the 2026 Part B premium, the combined Part B and Part D surcharge and how far you are from the next bracket. It uses the CMS and SSA tables above and nothing else. Remember the income SSA uses is generally from two tax years back.
🧮 Medicare IRMAA Calculator (2026 amounts)
Try $109,000 and then $109,001 as a single filer. The second figure moves the Part B total from $202.90 to $284.10, a difference of $974.40 a year from one dollar of income, plus $174.00 a year if you have drug coverage. For a couple filing jointly at $218,001, both spouses pay the higher amount, so the household surcharge is double.
6. Why the Brackets Behave Like Cliffs
Because each bracket carries a flat dollar surcharge, the premium does not rise smoothly with income. The practical effect is that income just above a threshold can cost far more in premiums than the same income just below it. Using the 2026 table, a single filer whose MAGI is $137,000 pays a $81.20 monthly surcharge, while one at $137,001 pays $202.90, a jump of $121.70 a month ($1,460.40 a year) on a single dollar.
That is the reason people who manage their income often pay attention to the bracket edges. It is also why a clear view of the thresholds matters more than precise estimating of every deduction. There are two cautions. First, the thresholds are indexed to inflation each year, so the numbers above will change for 2027. Second, the income SSA uses may differ from the figure you would estimate today, because the two-year gap means the relevant return may already be filed.
7. What Can Raise MAGI
Because MAGI starts from adjusted gross income, anything that increases AGI can push you toward a bracket, and tax-exempt interest is added on top. Common sources worth knowing about, with our deeper guides:
- Required minimum distributions. Withdrawals from traditional retirement accounts are taxable income. See our RMD calculator.
- Realized capital gains. Selling appreciated assets raises AGI in the year of the sale. See capital gains tax rates and strategies and tax-loss harvesting.
- Roth conversions. Converting pre-tax money to Roth adds the converted amount to income that year. Our Backdoor Roth and pro-rata guide explains the related mechanics.
- Taxable Social Security. Up to 85% of benefits can be taxable, which feeds into AGI. See our guide to Social Security claiming age and the tax thresholds in it.
- Pensions, wages and interest. Ordinary income of any kind counts, and so does tax-exempt interest.
On the other side, our HSA guide and the tax bracket calculator show how income and deductions interact with the tax side of the picture. IRMAA brackets are separate from tax brackets, so check each on its own.
8. Asking for a New Decision
If your income has dropped since the year SSA used, you may be able to ask for a new decision. According to SSA, qualifying life-changing events include:
- You married or divorced, or your spouse died.
- You or your spouse stopped working or reduced work hours.
- You lost income-producing property in a disaster or other event beyond your control.
- A scheduled cessation, termination or reorganization of an employer's pension plan.
- A settlement from an employer or former employer because of its closure, bankruptcy or reorganization.
You submit Form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event," with supporting documents such as a death certificate or an employer's retirement letter. If you filed a federal return for the year, SSA asks for a signed copy.
Separately, you can ask for reconsideration if you think the information SSA used was wrong. SSA calls online filing the fastest way, and you can also send Form SSA-561-U2 or call 1-800-772-1213. If the income figure that came from the IRS is wrong, SSA says to correct it with the IRS first. You do not have to appeal to request a new decision after a qualifying event.
9. How It Is Paid
SSA says the additional Part D amount is deducted from your monthly Social Security payment, regardless of how you usually pay your drug plan premium. If the amount is larger than your payment, or you do not receive monthly Social Security, you get a separate bill from another federal agency (CMS or the Railroad Retirement Board). If you are already paying an adjustment and sign up for the other program later in the year, SSA says the adjustment is applied automatically without a new letter. For drug coverage problems, SSA directs people to 1-800-MEDICARE (1-800-633-4227).
10. The 2027 Outlook
As of October 22, 2026, CMS has not announced the 2027 Part B premium; it is typically published in the fall. AARP reported on October 5, 2026 that the Medicare Trustees projected a standard premium of $209.50 for 2027 and a deductible of $292, but a projection is not the final figure. The IRMAA thresholds also change with inflation. We will update the tables and the calculator once CMS publishes, and log the change in the archive below.
11. Checklist and Common Mistakes
- Find the right year. Identify which tax year SSA is using for your current premium (generally two years back).
- Check your MAGI. Add tax-exempt interest to AGI and compare with your filing-status column.
- Look at the edges. If you are close to a threshold, see how much room you have in the calculator.
- Check the letter. Read the SSA letter for the reason and the income year used.
- If your life changed, look at the five qualifying events and Form SSA-44.
- If the data is wrong, ask for reconsideration or correct the IRS record first.
- Plan for two people. A couple pays the surcharge twice.
Common mistakes include forgetting tax-exempt interest, assuming the surcharge is a percentage of the extra dollar, assuming only current-year income counts, and missing that married-filing-separately has a very different schedule.
12. Frequently Asked Questions
The CMS 2026 fact sheet lists a standard Part B premium of $202.90 per month and an annual Part B deductible of $283.
A surcharge applies when modified adjusted gross income is above $109,000 for an individual or above $218,000 for a married couple filing jointly, according to CMS. The highest bracket starts at $500,000 for individuals and $750,000 for joint filers.
SSA generally uses the return from two years before the premium year and never more than three years prior. For 2026 premiums it generally uses 2024 income, and sometimes 2023.
SSA defines it as adjusted gross income from page 1 of Form 1040 plus tax-exempt interest income reported on line 8b.
The surcharge is set per enrolled person, so on a joint return each spouse who has Part B (and Part D) pays the amount for that bracket.
Yes. SSA says you can request reconsideration online, with Form SSA-561-U2, at a local office or by phone. If your income dropped because of a qualifying life-changing event, you can request a new decision with Form SSA-44 without an appeal.
SSA's 2026 chart shows monthly Part D add-ons of $14.50, $37.50, $60.40, $83.30 and $91.00 across the five surcharge brackets. It is added to your plan's own premium and is deducted from Social Security.
Not as of October 22, 2026. CMS typically announces it in the fall. A Trustees projection of $209.50 has been reported, but the official figure may differ.
13. Update Archive
✅ Key Takeaways
- The 2026 standard Part B premium is $202.90; IRMAA adds up to $487.00 a month on top.
- MAGI is AGI plus tax-exempt interest, generally from two tax years before the premium year.
- Brackets are cliffs: one dollar over a threshold can cost nearly a thousand dollars a year or more.
- Part D adds $14.50 to $91.00 a month for people with drug coverage.
- Five life-changing events can support a new decision using Form SSA-44.
- CMS has not yet announced 2027 premiums.
Official Resources & Further Reading
📎 Sources & References
- Centers for Medicare & Medicaid Services, 2026 Medicare Parts A & B Premiums and Deductibles
- Social Security Administration, Medicare Premiums: Rules for Higher-Income Beneficiaries
- SSA, Handbook 2501: What is Modified Adjusted Gross Income (MAGI)?
- SSA, Form SSA-44, Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event
- AARP, Medicare Part B Premium 2027 (reporting the Trustees projection, October 5, 2026)