Speak to a Licensed Insurance Agent: 
Medicare IRMAA 2026: Income Brackets, Premiums, and Appeals
A higher income can affect more than your tax bill after you enroll in Medicare. In 2026, some beneficiaries pay extra for Part B and Part D when income in an earlier tax year was high. This lookback can make a new premium notice feel unexpected.
Talk with a licensed Medicare agent about your IRMAA notice by calling (877) 255-6273 today.
Medicare IRMAA 2026 is an income-related adjustment added to standard Part B and Part D costs when your modified adjusted gross income exceeds federal thresholds. Social Security generally uses your tax return from two years ago, but a qualifying life-changing event may give you a reason to request a new determination.
Understanding the terms, income calculation, and surcharge tiers can help you check whether the notice matches your situation. It also clarifies when an appeal may be appropriate. We will start with what IRMAA means, how the lookback works, and why both Part B and Part D can be affected.
What Is the Medicare IRMAA in 2026?
IRMAA is a surcharge that may be added to your Medicare premiums when your income is above Medicare’s annual thresholds. It can affect both Part B and Part D, but not Part A. In 2026, roughly 7% to 8% of people enrolled in Part B are expected to pay this additional amount. Understanding how the calculation works can make an unexpected premium notice easier to evaluate.
What does IRMAA stand for?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is paid on top of the standard Part B premium and, when applicable, the premium for Part D prescription drug coverage. The standard Part B premium is $202.90 per month in 2026. If your income places you in an IRMAA tier, your total Part B premium will be higher. Part D IRMAA is separate from your plan’s regular premium.
IRMAA is based on modified adjusted gross income, usually called MAGI. For this purpose, MAGI generally means your adjusted gross income plus tax-exempt interest. Social Security receives income information from the IRS and uses it to determine whether an adjustment applies. You do not normally submit a separate income form to Medicare for this calculation.
Why does 2026 matter?
The important detail is the two-year lookback. Your 2024 federal tax return generally provides the income information used to set your 2026 Medicare premiums. That means a large withdrawal, capital gain, or other income event in 2024 can affect what you pay in 2026, even if your current income is lower.
Social Security uses the IRS information and sends you a notice explaining the exact Part B amount you will pay. Review the income and filing status shown on that notice. A married couple filing jointly is evaluated under different thresholds than someone filing individually. If you had a major life-changing event and your income has fallen, you may have options to ask Social Security for a new determination.
For a closer look at the standard premium and how it fits into your budget, read our 2026 Medicare Part B premium guide. A licensed Medicare advisor can also help you compare the notice with your tax records and identify the next step.
Sources: Medicare costs in 2026 and Social Security Medicare premiums guidance.
2026 Medicare IRMAA Income Brackets for Part B
Your 2026 Part B premium depends on your modified adjusted gross income and tax filing status. The table below shows the monthly total premium for individual and joint filers. These figures come from the Medicare Costs fact sheet.
| Filing status | MAGI range | Monthly total premium |
|---|---|---|
| Individual | $109,000 or less | $202.90 |
| Individual | Above $109,000 up to $137,000 | $284.10 |
| Individual | Above $137,000 up to $171,000 | $405.80 |
| Individual | Above $171,000 up to $205,000 | $527.50 |
| Individual | Above $205,000 and less than $500,000 | $649.20 |
| Individual | $500,000 or above | $689.90 |
| Joint | $218,000 or less | $202.90 |
| Joint | Above $218,000 up to $274,000 | $284.10 |
| Joint | Above $274,000 up to $342,000 | $405.80 |
| Joint | Above $342,000 up to $410,000 | $527.50 |
| Joint | Above $410,000 and less than $750,000 | $649.20 |
| Joint | $750,000 or above | $689.90 |
How to read the table
The listed amount is your total monthly Part B premium. It combines the standard 2026 Part B premium of $202.90 with any applicable IRMAA amount. IRMAA is the income-related adjustment added when your income falls above the applicable threshold.
If you are married and file separately, the rules can work differently. If you lived with your spouse during the tax year and your income is above $109,000, your Part B premium jumps to the $649.20 tier. Because filing status and the two-year income lookback both matter, compare your SSA notice with your tax information before budgeting for the year.
2026 Part D IRMAA Surcharge Tiers
Part D IRMAA is separate from the Part B adjustment. If your income is above the applicable 2026 threshold, you pay a monthly surcharge in addition to your Medicare prescription drug plan premium. Your plan’s premium still varies by insurer, plan, coverage area, and benefits. The surcharge does not replace that premium.
| Tax filing status and modified adjusted gross income | Part D IRMAA added each month |
|---|---|
| Individual: $109,000 or less; joint: $218,000 or less | $0 |
| Individual: above $109,000 to $137,000; joint: above $218,000 to $274,000 | $14.50 |
| Individual: above $137,000 to $171,000; joint: above $274,000 to $342,000 | $37.50 |
| Individual: above $171,000 to $205,000; joint: above $342,000 to $410,000 | $60.40 |
| Individual: above $205,000 and below $500,000; joint: above $410,000 and below $750,000 | $83.30 |
| Individual: $500,000 or more; joint: $750,000 or more | $91.00 |
For example, a beneficiary in the second tier pays the selected Part D plan premium plus $14.50 each month. The surcharge applies even if the plan itself has a different premium, including a $0 premium plan. This is why comparing only the plan premium may not show your full monthly drug coverage cost.
Social Security generally deducts Part D IRMAA from your Social Security benefit. If you do not receive Social Security benefits, Medicare can bill you directly. CMS lists these 2026 amounts in its 2026 Medicare premiums and Part D IRMAA fact sheet. Check your SSA notice for the amount assigned to you, and review your plan premium separately before estimating your total monthly cost.
How Social Security Calculates Your IRMAA
Social Security does not calculate your IRMAA from a quick estimate of this year’s income. It generally uses the most recent federal tax return available, which is usually from two years earlier. For example, your 2024 tax return is used to determine your Medicare premiums for 2026.
The MAGI formula Social Security uses
For IRMAA purposes, modified adjusted gross income, or MAGI, is your adjusted gross income plus tax-exempt interest income. Tax-exempt interest can come from investments such as municipal bonds, so it may affect your IRMAA even though it is not included in your taxable income.
Social Security receives the income information directly from the Internal Revenue Service. You do not normally send Medicare a separate income report or calculate the surcharge yourself. Social Security uses that tax information to determine whether you pay an income-related amount in addition to your standard Part B premium and any applicable Part D premium. You can review the calculation details at Social Security’s Medicare premium page.
What if your income is lower now?
A two-year lookback can create an unexpected result after retirement. You may have had unusually high income from selling property, exercising investments, or receiving a bonus in 2024, even though your income is much lower in 2026. In that situation, the tax return used for your initial determination may not reflect your current circumstances.
Social Security will send you a notice explaining the IRMAA decision and the amount it says you will pay. If your current or expected income has changed because of a qualifying life-changing event, you can ask Social Security to reconsider the determination. Form SSA-44 is used for this request. You may need to provide documentation, such as an employer letter showing retirement or a statement showing reduced work.
When you appeal, Social Security may use your estimated income for the affected year, then compare that estimate with later tax information. An estimate is part of the appeal process, not a replacement for the tax return used in the standard calculation. You generally do not need to report ordinary income fluctuations yourself unless you are requesting a new determination or appealing an IRMAA notice.
Before planning for the surcharge, consider estimating your annual Medicare costs using your filing status, expected income, and current notice from Social Security. A full cost picture also includes how Part D coverage phases work, since drug spending outside the IRMAA surcharge can still change your monthly budget.
How to Appeal an IRMAA Determination with Form SSA-44
An IRMAA notice can feel alarming, especially when your current income no longer reflects the tax return used to set your Medicare premiums. If a qualifying life-changing event lowered your income, you may ask Social Security to review the determination. A reduction is not automatic, so you must file the request.
-
1. Confirm that a qualifying event applies
Form SSA-44 is designed for situations where a life-changing event reduced your income. Qualifying events include marriage, divorce or annulment, the death of a spouse, or stopping work. Reducing your work hours, losing income-producing property, losing pension income, or receiving an employer settlement payment can also qualify. Review the event carefully and connect it to the income change you are reporting.
-
2. Gather documentation
Collect documents that show both the event and, when appropriate, its effect on your income. Examples include a death certificate, marriage certificate, or letter from your employer confirming a work stoppage or reduction. Keep copies for your records. Clear documentation can help Social Security evaluate your request without unnecessary delays.
-
3. Complete Form SSA-44
Complete the Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event form, SSA-44. The form asks for information about the event, your expected income, and supporting evidence. Use your best reasonable estimate for the applicable year, and make sure the figures match the documents you submit.
-
4. Submit the request to Social Security
Submit the completed form and supporting documents to Social Security. Depending on the available options for your situation, you may submit information online through SSA.gov or follow the mailing instructions provided by Social Security. The form can be filed any time during the year, and SSA states that there is no penalty for requesting this review.
-
5. Wait for a new initial determination
After reviewing your form and evidence, Social Security makes a new initial determination. If approved, the revised decision can change the IRMAA amount used for your Medicare premiums. Keep the determination with your tax and Medicare records. If you disagree with the result, review the notice for the next appeal option and its deadline. A licensed Medicare agent can help you organize the facts and understand your choices, but Social Security makes the determination.
IRMAA appeals involve personal income details, but you do not have to navigate the paperwork alone. A licensed agent can help you prepare questions and identify the documents to discuss with Social Security. For guidance on timing and enrollment windows around an appeal, review our 2026 Medicare Open Enrollment overview.
Who Is Exempt from IRMAA? Dual-Eligible Beneficiaries and Medicare Savings Programs
IRMAA can make Medicare costs feel confusing, but it does not affect most beneficiaries. About 7% to 8% of Part B enrollees pay an income-related adjustment. That means the large majority pay the standard premium without an IRMAA surcharge.
Some people also receive help that prevents them from paying these costs themselves. The most common examples involve Medicaid, Medicare Savings Programs, and the Part D Extra Help program.
Dual eligibility and Medicare Savings Programs
A dual-eligible beneficiary has both Medicare and Medicaid. Medicaid can help with Medicare premiums and other out-of-pocket costs, depending on the person’s eligibility category and state rules. Dual-eligible beneficiaries are also typically enrolled automatically in a Medicare Savings Program, when the applicable program provides that assistance.
Medicare Savings Programs help qualifying people with limited income and resources pay Medicare expenses. For eligible enrollees, an MSP can pay the Part B premium. This assistance can be especially important when a beneficiary is concerned about a higher premium amount. Eligibility is not based on age alone, and limits can change, so check your state’s current requirements rather than assuming you do not qualify.
Learn more about how these programs work in our guide to Medicare Savings Programs. You can also read our dual-eligible Medicare and Medicaid plan guide to see how the two programs interact. For the official eligibility overview, visit Medicare.gov.
Extra Help and Part D IRMAA
Beneficiaries with limited income and resources may also qualify for Extra Help with Medicare Part D prescription drug costs. People receiving the full Part D low-income subsidy do not pay the Part D IRMAA amount. Extra Help is separate from Medicare Savings Program eligibility, so ask whether you qualify for both.
Although the first 2026 IRMAA income threshold increased to $109,000 for individual filers. Income is only one part of the picture, especially when your circumstances are tight or your income has recently fallen. A benefits counselor or licensed Medicare agent can help you identify assistance programs and understand which agency handles your application. If you are comparing coverage options, our Medicare coverage helpline guide explains how to get answers about benefits and costs.
Frequently Asked Questions
What are the 2026 IRMAA brackets?
For individual tax filers, the 2026 Part B premium ranges from the standard $202.90 per month at $109,000 or less, to $689.90 at $500,000 or above. Joint filers use thresholds from $218,000 to $750,000. Each income tier also has a separate Part D surcharge. See the Medicare 2026 cost tables for the complete brackets.
How are IRMAA surcharges calculated?
Social Security uses your modified adjusted gross income, or MAGI. MAGI generally includes your adjusted gross income plus tax-exempt interest. The agency receives income information from the IRS and applies the filing-status and income tier that matches your record. You pay the standard premium plus any applicable IRMAA amounts.
What is the two-year lookback rule for IRMAA?
Your 2026 IRMAA generally uses MAGI from your 2024 federal tax return. A major income change after that return may not appear in your initial determination. If a qualifying life event substantially lowered your income, you can ask Social Security to reconsider the amount.
Are IRMAA surcharges applied to both Part B and Part D?
Yes. Part B IRMAA increases your monthly Part B premium, while Part D IRMAA is a separate surcharge added to your prescription drug plan premium. For 2026, Part D surcharges range from $0 to $91.00 per month, depending on your MAGI and tax filing status.
How can I appeal an IRMAA determination?
You may qualify if a life-changing event, such as marriage, divorce, a spouse’s death, work stoppage, or reduced work, significantly lowered your income. Complete Form SSA-44 and provide supporting documentation. The reduction is not automatic, so submit the request to Social Security for review.
Ready to Talk Through Your IRMAA Options?
IRMAA notices can be difficult to interpret, especially when your income or circumstances have changed. A licensed Medicare agent can help you review the determination. You can understand how it affects your Part B and Part D costs and identify the next step. To talk with a licensed Medicare agent at My Senior Health Plan, call (877) 255-6273.
- Medicare IRMAA 2026: Income Brackets, Premiums, and Appeals - August 5, 2026
- Medicare Coverage While Traveling: What Seniors Need to Know - August 3, 2026
- Hospital Indemnity Insurance With Medicare: Coverage Guide - July 30, 2026
More from MySeniorHealthPlan
- Medicare IRMAA 2026: Income Brackets, Premiums, and Appeals - August 5, 2026
- Medicare Coverage While Traveling: What Seniors Need to Know - August 3, 2026
- Hospital Indemnity Insurance With Medicare: Coverage Guide - July 30, 2026
