Medicare Part A Overview
Medicare Part A helps cover care received in certain inpatient and facility-based settings, including:
- Inpatient hospital care
- Skilled nursing facility care
- Hospice care
- Inpatient rehabilitation services
- Some home health care services
Good News: Most Medicare beneficiaries do not pay a monthly premium for Part A because they — or their spouse — have at least 40 quarters, or 10 years, of Medicare-covered employment.
Medicare Part B Premiums
Part B has a monthly premium that is based on your income as of 2 years ago. 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 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.
Key Rules & Planning Considerations
The "Cliff" Effect
IRMAA brackets are strict cliffs. Crossing into a higher tier by even a single dollar triggers the full surcharge for that entire bracket for the entire calendar year.
What Counts as MAGI for IRMAA?
Your calculation starts with your Adjusted Gross Income (AGI) and adds back certain items, most notably tax-exempt municipal bond interest. It also includes taxable Social Security benefits, capital gains, traditional IRA/401(k) distributions, and Roth conversions.
Appealing an IRMAA Determination
If your income dropped significantly between 2024 and 2026 due to a qualifying Life-Changing Event, you don't have to accept these brackets blindly. You can submit Form SSA-44 to request a recalculation. Recognized events include:
- Work stoppage or work reduction (retirement or semi-retirement)
- Death of a spouse
- Marriage, divorce, or annulment
- Loss of income-producing property or pension income
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:
| Income Bracket | Part B Surcharge | Part D Surcharge |
|---|---|---|
| $109,000 or less | $0.00 | $0.00 |
| $109,001 to $390,999 | +$324.60 | +$83.30 |
| $391,000 or more | +$487.00 | +$91.00 |