Understanding IRMAA for 2026
The Income-Related Monthly Adjustment Amount (IRMAA) rules determine the surcharges added to your Medicare Part B and Part D premiums if your income exceeds specific thresholds.
For 2026, IRMAA assessments are based on your 2024 tax return (Modified Adjusted Gross Income, or MAGI), following Medicare's standard two-year lookback rule.
2026 Part B IRMAA Brackets & Surcharges
The base monthly premium for Medicare Part B in 2026 is $202.90. If your 2024 MAGI was at or below $109,000 (Single) or $218,000 (Joint), you pay only the standard base rate and no Part D surcharge.
| 2024 MAGI: Single Filers | 2024 MAGI: Married Filing Jointly | Part B IRMAA Surcharge | Total 2026 Part B Premium | Part D IRMAA Surcharge |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $202.90 | $0.00 (Plan Premium Only) |
| $109,001 to $137,000 | $218,001 to $274,000 | +$81.20 | $284.10 | +$14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | +$202.90 | $405.80 | +$37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | +$324.60 | $527.50 | +$60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | +$446.30 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | +$487.00 | $689.90 | +$91.00 |
Note: For Part D, the IRMAA surcharge is added directly to whatever baseline premium your specific prescription drug plan or Medicare Advantage plan charges.
2026 Part D IRMAA Surcharge Brackets
For 2026, the Income-Related Monthly Adjustment Amount (IRMAA) rules for Medicare Part D are based on your 2024 tax return (Modified Adjusted Gross Income, or MAGI).
Unlike Part B, where the surcharge is added to a fixed standard baseline, the Part D IRMAA surcharge is added directly to whatever baseline premium your specific prescription drug plan charges (whether it's a standalone Part D plan or the drug portion of a Medicare Advantage plan).
The national base beneficiary premium used to calculate these adjustments is $38.99 for 2026.
| 2024 MAGI: Single Filers | 2024 MAGI: Married Filing Jointly | Monthly Part D Surcharge | What You Pay Monthly |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | Your regular plan premium |
| $109,001 to $137,000 | $218,001 to $274,000 | +$14.50 | Plan Premium + $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | +$37.50 | Plan Premium + $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | +$60.40 | Plan Premium + $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | +$83.30 | Plan Premium + $83.30 |
| $500,000 or more | $750,000 or more | +$91.00 | Plan Premium + $91.00 |
Married Filing Separately
If you are married but file a separate tax return and live with your spouse at any time during the tax year, the brackets are much tighter:
- $109,000 or less: $0 surcharge
- $109,001 to $390,999: +$83.30 surcharge
- $391,000 or more: +$91.00 surcharge
Crucial Execution Details for Part D IRMAA
Payment Direct to Medicare
Unlike your standard Part D premium, which you usually pay directly to your private insurance carrier, the IRMAA surcharge must be paid directly to Medicare or the federal government. It is typically deducted automatically from your monthly Social Security check. If your check doesn't cover it (or you don't receive Social Security benefits yet), you will receive a bill from Medicare or the Railroad Retirement Board.
The "Cliff" Rules Apply
Just like Part B, Part D IRMAA thresholds are absolute cliffs. Going over a bracket limit by even a single dollar triggers the full monthly surcharge for that specific tier for all 12 months of 2026.
How MAGI is Tracked
For IRMAA purposes, MAGI is your Adjusted Gross Income (AGI) plus any tax-exempt municipal bond interest you received in 2024.
Requesting a Surcharge Review
If your income has significantly dropped since 2024 due to a major life change — such as the death of a spouse, retirement/work stoppage, or a work reduction — you can appeal the 2026 determination. You do this by submitting Form SSA-44 to the Social Security Administration along with documentation proving the life-changing event and your lower projected 2026 income.