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What Is IRMAA? Medicare’s Income-Related Surcharge Explained for 2026
Last Modified: 10/05/2026 | Reviewed by Keith Armbrecht (NPN 634015)
Quick Summary
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an additional amount certain higher-income Medicare beneficiaries pay for Medicare Part B and Part D.
In 2026, IRMAA begins when modified adjusted gross income exceeds $109,000 for an individual filer or $218,000 for married couples filing jointly.
Social Security generally uses tax information from two years earlier to determine IRMAA, meaning 2026 IRMAA is generally based on your 2024 tax return. (CMS)
Key Facts
- IRMAA affects Medicare Part B.
- IRMAA also affects Medicare Part D.
- About 8% of beneficiaries pay income-related Medicare adjustments.
- 2026 first threshold: above $109,000 single.
- 2026 first threshold: above $218,000 married filing jointly.
- IRMAA uses modified adjusted gross income.
- Medicare generally looks back two tax years.
- IRMAA is recalculated each year.
- A qualifying life-changing event may allow you to request a new determination.
- Retirement can potentially qualify as a life-changing event.
- IRMAA is separate from your health plan premium. (CMS)
2026 Part B IRMAA Brackets
Individual / Married Filing Jointly
$109,000 or less / $218,000 or less
Part B premium: $202.90
Above $109,000–$137,000 / Above $218,000–$274,000
Part B premium: $284.10
Above $137,000–$171,000 / Above $274,000–$342,000
Part B premium: $405.80
Above $171,000–$205,000 / Above $342,000–$410,000
Part B premium: $527.50
Above $205,000–below $500,000 / Above $410,000–below $750,000
Part B premium: $649.20
$500,000 or more / $750,000 or more
Part B premium: $689.90 (CMS)
2026 Part D IRMAA
Higher-income beneficiaries also pay an additional Medicare Part D amount.
The 2026 monthly Part D IRMAA amounts range from:
$14.50
to
$91.00
depending on income.
This amount is paid in addition to your Part D plan premium. (CMS)
Why Does Medicare Use Old Income?
Social Security generally uses the most recent tax return information available from the IRS.
For 2026, that will ordinarily mean 2024 income.
That can create a problem when someone had high income two years ago but has now retired.
Can IRMAA Be Appealed?
Potentially.
If your income dropped because of an eligible life-changing event, you can ask Social Security to reconsider the income being used.
Examples can include certain situations involving:
- Retirement or work stoppage
- Reduction in work
- Marriage
- Divorce
- Death of a spouse
- Loss of certain income-producing property
- Loss of pension income
- Employer settlement payments
Video Explanation from Keith
Why Is My Medicare Premium So High? IRMAA Explained
Keith's Take
IRMAA catches a lot of new retirees by surprise.
They retire expecting their income to fall dramatically, then Medicare looks backward at a tax return from when they were still earning a large salary.
The first thing I ask is:
Has something changed since that tax return?
If you retired, reduced work or had another qualifying life-changing event, don’t automatically assume you have to accept that higher premium without review.
Keith Armbrecht
Medicare on Video
Frequently Asked Questions About IRMAA
Q. What does IRMAA stand for?
A. What does IRMAA stand for?
Q. Who pays IRMAA?
A. Certain higher-income Medicare Part B and Part D beneficiaries.
Q. What income triggers IRMAA in 2026?
A. Above $109,000 for individual filers or $218,000 for married couples filing jointly begins the first IRMAA tier.
Q. What tax year does Medicare use for 2026 IRMAA?
A. Generally 2024.
Q. Is IRMAA permanent?
A. Not necessarily. It's recalculated annually
Q. Does IRMAA apply to Medigap?
A. No. It's an adjustment to Part B and Part D costs.
Q. Can retirement reduce IRMAA?
A. Potentially, if retirement results in lower income and qualifies for a new determination.
Q. Can I appeal IRMAA?
A. Yes, under qualifying circumstances.
Official Government Sources
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