Medicare IRMAA: The Income-Related Surcharge, Explained
IRMAA (the Income-Related Monthly Adjustment Amount) is an extra charge added to your Medicare Part B and Part D premiums when your income is above a threshold — $109,000 for a single filer or $218,000 for a married couple in 2026. Social Security uses your MAGI from 2024 to decide. If your income has since dropped because of a life-changing event, you can appeal.
Income above a threshold?IRMAA may add to your monthly premiums.
How IRMAA Works
Every year, Social Security looks at your Modified Adjusted Gross Income (MAGI) — your adjusted gross income plus any tax-exempt interest — from two years back. For 2026, that means your 2024 tax return. If that number is above $109,000 (single) or $218,000 (married filing jointly), you fall into an IRMAA tier and pay a surcharge on top of the standard premium.
The surcharge applies to both parts:
- Part B IRMAA is added directly to your Part B premium.
- Part D IRMAA is billed separately by Social Security — on top of whatever your drug plan already charges.
See the full 2026 IRMAA brackets for the exact dollar amounts at each income tier, or estimate your surcharge from your income.
The Two-Year Lookback Is the Catch
Because IRMAA uses income from two years ago, a one-time spike — selling a home, a large Roth conversion, cashing out investments — can trigger a surcharge in a year when your income is actually much lower.
Good news: IRMAA is recalculated every year, so it corrects itself as newer returns come in.
If Your Income Dropped, You Can Appeal
You don't always have to wait two years. If your income fell because of a qualifying life-changing event — retirement, the death of a spouse, divorce, and more — you can appeal your IRMAA with Form SSA-44 and have Social Security use your current income instead.
Learn about Form SSA-44Where to Go Next
Take the next step to understand your surcharges and options.
Frequently Asked Questions
What income does IRMAA use?
Your Modified Adjusted Gross Income (MAGI) — adjusted gross income plus tax-exempt interest — from your tax return two years ago. For 2026, that's your 2024 return.
Does IRMAA go away if my income drops?
Yes. IRMAA is recalculated every year from your latest return, so a lower income eventually lowers it automatically. If the drop came from a qualifying life-changing event, you can appeal now instead of waiting two years.
Is IRMAA the same for Part B and Part D?
The income tiers are the same, but the dollar amounts differ. Part B IRMAA is added to your Part B premium; Part D IRMAA is billed separately by Social Security, on top of whatever your drug plan charges.
Sources
- Medicare Part B costs (IRMAA) Medicare.gov
- Medicare premiums: Rules for higher-income beneficiaries Social Security Administration
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Talk to a Local, Licensed Agent
IRMAA planning is one of the most valuable things a good agent does. If you're near a threshold, call us free — a small move can save a full tier.