Medicare and IRMAA
Medicare IRMAA Brackets for 2026: Income Thresholds and What You Pay
In 2026 the standard Medicare Part B premium is $202.90 a month. IRMAA, the income-related monthly adjustment amount, applies when modified adjusted gross income on your 2024 tax return exceeds $109,000 for a single filer or $218,000 for a joint return, and it raises Part B to as much as $689.90 a month.
Figures verified October 14, 2026 against CMS, 2026 Medicare Parts A & B Premiums and Deductibles (14 November 2025) and Social Security Administration, Medicare Premiums: Rules for Higher-Income Beneficiaries. Educational information, not advice.
What are the 2026 IRMAA brackets for Part B and Part D?
Since 2007 the Part B premium has depended on income, and since 2011 so has Part D. The Centers for Medicare & Medicaid Services published the 2026 table on November 14, 2025. Roughly 8% of people with Part B pay a surcharge. The thresholds below are modified adjusted gross income, which is adjusted gross income plus tax-exempt interest.
| Single return, MAGI | Joint return, MAGI | Part B surcharge | Part B total per month | Part D surcharge |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $202.90 | $0.00 |
| $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 |
Part D surcharges are paid on top of whatever premium your drug plan charges, and are collected by Medicare, not the plan. Married people who lived with their spouse during the year but file separately use a different table: no surcharge up to $109,000, then $446.30 for Part B and $83.30 for Part D up to $391,000, and $487.00 and $91.00 above that.
Why does 2024 income set 2026 premiums?
Social Security uses the most recent tax return the IRS has supplied, which is normally the one filed the previous spring for the year before that. For 2026 premiums that is the 2024 return. The lag is the part many people miss. A Roth conversion, a large IRA withdrawal, the sale of a property or a final year of high earnings does not change this year's premium. It arrives two years later, as a letter from Social Security, for every month of that year.
Why is one dollar over the line so expensive?
IRMAA is a cliff. Income one dollar above a threshold moves the whole premium to the next tier for the entire year, and each spouse on Medicare pays separately. Crossing from the first tier into the second on a joint return adds $81.20 a month for Part B and $14.50 for Part D per person, which is more than $2,290 for the couple over the year, before any plan premium. The difference between the bottom tier and the top is $487.00 a month per person for Part B alone.
How do Roth conversions and withdrawals interact with IRMAA?
A conversion or withdrawal adds to adjusted gross income in the year it happens. That is why we build conversions as a multi-year structure rather than a single event: the goal is to fill the lower federal brackets each year while staying under the IRMAA line that applies to that year's income, two years ahead of when it bites. Michigan's retirement income deduction lowers state tax on the same withdrawal but does nothing for IRMAA, which is federal.
Can a lower income get you a lower tier?
Yes, in defined circumstances. If a life-changing event has reduced your income, such as stopping work, reducing hours, divorce, the death of a spouse or the loss of income-producing property, you can ask Social Security to base IRMAA on a more recent year by filing form SSA-44 with evidence. Retiring is the most common qualifying event, and many new retirees pay a surcharge in their first Medicare year that an appeal would have removed.
CMS resets the thresholds and surcharges every November. The first four thresholds are indexed to inflation. The top tier is fixed at $500,000 and $750,000. We update this page when the 2027 figures are released.
Frequently asked
Questions this table answers.
What are the Medicare IRMAA income limits for 2026?
For 2026, IRMAA begins when modified adjusted gross income exceeds $109,000 on a single return or $218,000 on a joint return, per the CMS fact sheet of November 14, 2025. There are five surcharge tiers above that, topping out at $500,000 single or $750,000 joint, where the Part B premium reaches $689.90 a month.
Which year's income does IRMAA use?
Social Security sets your IRMAA from the most recent federal tax return the IRS has provided, which is generally the return from two years earlier. Your 2026 premiums are based on your 2024 income. A large withdrawal or Roth conversion in one year therefore shows up in Medicare premiums two years later.
What happens if I go one dollar over an IRMAA threshold?
You pay the full surcharge for the next tier on every month of that year. IRMAA is a cliff, not a slope: the surcharge applies to the whole premium once income passes a line, not just to the dollars above it. Each spouse on Medicare pays the surcharge separately, so a joint return that crosses a line is charged twice.
Can you appeal an IRMAA decision?
Yes. If your income has dropped because of a life-changing event such as retirement, reduced work hours, divorce or the death of a spouse, you can ask Social Security to use a more recent year's income by filing form SSA-44. The Social Security Administration lists the qualifying events in its publication on premiums for higher-income beneficiaries.
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