Understanding IRMAA: Income-Related Medicare Premiums
Higher-income Medicare beneficiaries pay more for Part B and Part D through IRMAA. Learn how it is calculated, the 2026 thresholds, and how to request a review after a life change.
The short version
- IRMAA adds a surcharge to Part B and Part D premiums for people with higher incomes.
- It is based on modified adjusted gross income from two years earlier.
- You can ask Social Security to use more recent income after certain life-changing events, such as retirement.
In this guide
Most people pay the standard Part B premium, which is $202.90 per month in 2026. But people with higher incomes pay an extra amount for Part B and Part D, called the Income-Related Monthly Adjustment Amount, or IRMAA.
How IRMAA works
Social Security determines whether you owe IRMAA based on your modified adjusted gross income (MAGI) from your federal tax return from two years earlier. For 2026 premiums, that generally means your 2024 tax return.
MAGI for this purpose is your adjusted gross income plus tax-exempt interest income.
The 2026 thresholds
For 2026, IRMAA generally applies if your 2024 MAGI was:
- Above $109,000 for individuals filing single
- Above $218,000 for married couples filing jointly
There are several income brackets above these thresholds. The higher your income, the larger the surcharge. For 2026, the Part B surcharge ranges from about $81 to $487 per month on top of the standard premium, and the Part D surcharge ranges from about $14.50 to $91 per month on top of your plan premium.
Different rules apply for married people who file separately. Thresholds and amounts are updated each year.
How you will know
If you owe IRMAA, Social Security will send you a letter explaining the amount and the income information used. The surcharge is typically deducted from your Social Security benefit or billed to you.
Life-changing events: requesting a new determination
Because IRMAA looks back two years, it may not reflect your current income. This is common in the first years after retirement, when income often drops. You can ask Social Security to use more recent income if you have experienced a life-changing event, such as:
- Work stoppage or reduction (including retirement)
- Marriage, divorce or annulment
- Death of a spouse
- Loss of income-producing property
- Loss or reduction of certain pension income
- Receipt of a settlement from an employer due to closure or bankruptcy
To request this, you can complete Form SSA-44 ("Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event") and provide documentation. You can also contact Social Security.
If you believe the income information is wrong, for example, if you filed an amended return, you can also request a review.
One-time income spikes
A large one-time income event, such as selling property or converting a traditional IRA to a Roth IRA, can push your MAGI above a threshold for that year and affect your premiums two years later. Because IRMAA brackets work like cliffs, even one dollar over a threshold can trigger a higher bracket. If you are planning a large transaction, consider discussing the timing with a tax professional.
Things that do not count as life-changing events
Generally, one-time income events like selling a home or taking a large retirement account withdrawal are not considered life-changing events for an IRMAA appeal.
Get help
- Social Security: 1-800-772-1213 or ssa.gov
- Your State Health Insurance Assistance Program (SHIP) for free counseling
- A tax professional for planning around income
Terrameritavi is an independent publication and is not affiliated with Medicare, Social Security or any government agency. This article is general information, not tax or financial advice.
