IRMAA — Income-Related Monthly Adjustment Amount
Higher-income Medicare beneficiaries pay more for Part B and Part D. Here's what you need to know.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B (medical insurance) and Medicare Part D (prescription drug) premiums if your income exceeds certain thresholds.
The Social Security Administration (SSA) determines your IRMAA based on your Modified Adjusted Gross Income (MAGI) from your federal tax return filed two years prior. For example, your 2026 Medicare premiums are based on your 2024 tax return.
IRMAA is not a penalty — it is simply a sliding-scale surcharge. If your income drops in a later year, your IRMAA will be recalculated and may be reduced or eliminated.
How IRMAA Is Calculated
SSA reviews your tax return
The Social Security Administration looks at your MAGI from the federal tax return filed two years before the coverage year.
Your income is compared to thresholds
If your MAGI exceeds the base threshold, you are placed into one of five income brackets, each with a higher surcharge.
Surcharge is added to your premium
The IRMAA surcharge is added on top of the standard Part B and/or Part D premium. You are notified by SSA via letter.
You can appeal if your income changed
If you experienced a life-changing event (retirement, divorce, death of spouse, etc.) that reduced your income, you can file Form SSA-44 to request a lower IRMAA.
2026 Part B IRMAA Brackets & Surcharges
Based on 2024 MAGI. The base monthly Part B premium for 2026 is $202.90. If your MAGI was at or below $109,000 (Single) or $218,000 (Joint), you pay only the standard base rate.
| Individual MAGI (2024) | Joint MAGI (2024) | Total Monthly Premium | IRMAA Surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | +$81.20 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | +$202.90 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | +$324.60 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 | +$446.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$487.00 |
2026 Part D IRMAA Surcharge Brackets
The national base beneficiary premium used to calculate these adjustments is $38.99 for 2026. Unlike your standard Part D premium (paid to your carrier), the IRMAA surcharge is paid directly to Medicare — typically deducted from your Social Security check.
| Individual MAGI (2024) | Joint MAGI (2024) | Monthly Surcharge | What You Pay |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | Your regular plan premium |
| $109,001 – $137,000 | $218,001 – $274,000 | +$14.50 | Plan premium + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | +$37.50 | Plan premium + $37.50 |
| $171,001 – $205,000 | $342,001 – $410,000 | +$60.40 | Plan premium + $60.40 |
| $205,001 – $499,999 | $410,001 – $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:
| Individual MAGI (2024) | Monthly Surcharge |
|---|---|
| $109,000 or less | $0 surcharge |
| $109,001 – $390,999 | +$83.30 surcharge |
| $391,000 or more | +$91.00 surcharge |
The "Cliff" Rule
IRMAA thresholds are absolute cliffs. Going over a bracket limit by even a single dollar triggers the full monthly surcharge for that tier for all 12 months of the year. Careful income planning before year-end can make a significant difference.
How MAGI Is Calculated
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 or work stoppage, or a work reduction — you can appeal the 2026 determination. Submit Form SSA-44 to the Social Security Administration along with documentation proving the life-changing event and your lower projected income.
Download Form SSA-44 at ssa.gov/forms/ssa-44.pdf or call us and we'll walk you through the process.
Not Sure How IRMAA Affects Your Plan?
We'll review your income situation and help you understand exactly what you'll pay — and whether there are strategies to reduce your Medicare costs.