Costs and premiums
What is IRMAA, and how does income affect Medicare premiums?
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Short answer
IRMAA, the income-related monthly adjustment amount, is an extra charge added to the Medicare Part B and Part D premiums of people with higher incomes.
For 2026, IRMAA applies when modified adjusted gross income on the 2024 tax return was above $109,000 for an individual or $218,000 for a married couple filing jointly, and the Part B premium rises in steps from $202.90 to as much as $689.90 a month.
Social Security decides IRMAA from your tax return from two years earlier, and you can ask it to use a more recent year if your income dropped after a life-changing event such as retirement.
| Fact | Figure | Source |
|---|---|---|
| Income where IRMAA starts | Above $109,000 individual; above $218,000 married filing jointly | CMS, 2026 Medicare Parts A & B fact sheet |
| Tax year used | 2024 (two years before 2026) | Social Security |
| Part B premium with IRMAA | $202.90 standard, up to $689.90 a month | CMS, 2026 Medicare Parts A & B fact sheet |
| Part D | A surcharge added to the drug plan premium, paid to Medicare | CMS, 2026 Medicare Parts A & B fact sheet |
| How to ask for a new decision | Form SSA-44 after a life-changing event | Social Security |
| 2027 brackets | Not announced yet | CMS |
How is IRMAA calculated?
Social Security uses your modified adjusted gross income (MAGI): your adjusted gross income plus tax-exempt interest, from the tax return filed two years earlier. For 2026 premiums that is the 2024 return. Income is compared with the brackets for your filing status; married people who file separately and lived with their spouse use a different, shorter schedule.
Higher-income surcharges
2026 IRMAA income brackets
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. Your 2026 surcharge is based on your 2024 tax return.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.50 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.20 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Can I appeal IRMAA or get it lowered?
Yes. If your income went down because of a life-changing event, you can ask Social Security to use a more recent year's income with Form SSA-44. The qualifying events are marriage, divorce or annulment, the death of a spouse, stopping work, working fewer hours, the loss of income-producing property, the loss or reduction of a pension, and an employer settlement payment.
If you think Social Security used the wrong income, for example an amended return or a one-time sale counted twice, you can ask for a reconsideration. IRMAA is recalculated every year, so a one-year spike in income raises premiums for that year only.
Does IRMAA apply to Medicare Advantage?
Yes. IRMAA is tied to Part B and Part D, not to how you get your coverage. People in Medicare Advantage plans pay the Part B IRMAA, and the Part D IRMAA if their plan includes drug coverage. The surcharge is paid to Medicare (usually deducted from Social Security), not to the plan.
When are the 2027 IRMAA brackets announced?
With the 2027 Part B premium, usually in November. 2027 IRMAA is based on 2025 income, the tax return filed in 2026.
Good to know
More questions people ask
What income counts for IRMAA?
Is IRMAA permanent?
How do I know if I owe IRMAA?
Does IRMAA apply to Part D?
Related questions
In depth
- CMS: 2026 Medicare Parts A & B premiums and deductibles
- Social Security: Premiums for higher-income beneficiaries
- Medicare.gov: Medicare costs
Figures are Medicare’s, set nationally, and were checked against these pages on October 2026. For your own situation, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).
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This page was last updated: October 2026.