In short
- IRMAA uses your tax return from 2 years earlier: 2024 income sets 2026 premiums, and 2025 income sets 2027 premiums.
- In 2026, Part B ranges from $202.90 to $689.90 a month and the Part D add-on from $0 to $91.00, depending on income.
- Going $1 over a bracket line triggers the whole surcharge for that bracket, so income near a threshold matters.
- For 2027, the first threshold rises to $111,000 single and $222,000 joint; the full 2027 brackets come out in November.
- Retiring, a spouse's death, divorce and five other life-changing events let you ask Social Security to use your current, lower income.
IRMAA, the income-related monthly adjustment amount, is an extra charge added to your Part B and Part D premiums when your income is above certain limits. CMS says it affects about 8% of people with Part B. For 2026, it starts when your 2024 modified adjusted gross income was more than $109,000 on an individual return or $218,000 on a joint return.
The two things people miss: it looks back two years, and you can appeal it when your income drops.
What are the 2026 IRMAA brackets?
The tables below show the total monthly Part B premium per person, plus the Part D add-on, which is charged on top of whatever your drug plan costs. These are official 2026 figures from CMS.
Individual and joint filers, 2026:
| 2024 MAGI, individual return | 2024 MAGI, joint return | Part B premium per person | Part D add-on per person |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Over $109,000 up to $137,000 | Over $218,000 up to $274,000 | $284.10 | $14.50 |
| Over $137,000 up to $171,000 | Over $274,000 up to $342,000 | $405.80 | $37.50 |
| Over $171,000 up to $205,000 | Over $342,000 up to $410,000 | $527.50 | $60.40 |
| Over $205,000 and under $500,000 | Over $410,000 and under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Married filing separately, if you lived with your spouse at any time in the year, 2026:
| 2024 MAGI | Part B premium | Part D add-on |
|---|---|---|
| $109,000 or less | $202.90 | $0.00 |
| Over $109,000 and under $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91.00 |
With a joint return, each spouse on Medicare pays the amount in the table. Both spouses' premiums are based on your combined joint MAGI.
How does the 2-year lookback work?
Social Security uses the most recent tax return the IRS has, which is generally from two years before the premium year. For 2026 premiums, that is your 2024 return. MAGI here means the adjusted gross income on your Form 1040 plus any tax-exempt interest.
| Premium year | Tax year used | First threshold (individual / joint) |
|---|---|---|
| 2026 | 2024 | $109,000 / $218,000 |
| 2027 | 2025 | $111,000 / $222,000 |
| 2028 | 2026 | Not announced |
If the IRS does not have your two-year-old return yet, Social Security can use the return from three years before. If that older year was higher, you can ask Social Security to redo the calculation with your two-year-old return.
The practical result: your income at 63 sets your Medicare premiums at 65. A big final-year bonus, a pension lump sum, selling a business or a large Roth conversion in the years just before Medicare can show up as IRMAA later.
What are the 2027 IRMAA brackets?
Only the first line is official so far. Medicare & You 2027 says the 2027 IRMAA starts above $111,000 for individual filers and $222,000 for joint filers, based on 2025 income. The higher bracket lines, the 2027 surcharge amounts and the 2027 standard Part B premium are not announced yet. CMS usually releases them in November, and this page will be updated then.
How much does IRMAA cost? Three worked examples
Example 1: a couple just over the first line. A Lincoln couple filed jointly with a 2024 MAGI of $230,000. Each of them pays $284.10 for Part B (instead of $202.90) and $14.50 on top of their Part D premiums in 2026. That is $95.70 a month more per person, $191.40 a month for the couple, or $2,296.80 for the year.
Example 2: the $1 cliff. IRMAA is not phased in. A single filer with a 2024 MAGI of exactly $109,000 pays the standard $202.90. At $109,001, the full first-tier surcharge applies: $81.20 more for Part B and $14.50 for Part D, or $1,148.40 more for 2026 because of one dollar.
Example 3: a higher bracket. A single filer with a 2024 MAGI of $150,000 pays $405.80 for Part B and $37.50 on top of the Part D premium. That is $240.40 a month above standard, or $2,884.80 for 2026.
Can you appeal IRMAA?
Yes, in two ways.
1. A life-changing event. If your income went down because of one of the events Social Security recognizes, you can ask for a new determination using a more recent tax year, or an estimate if you have not filed yet. The recognized events are:
- Death of a spouse
- Marriage
- Divorce or annulment
- Work reduction
- Work stoppage (retirement counts)
- Loss of income-producing property
- Loss of employer pension income
- Receipt of a settlement payment from a current or former employer
You can report the event on Form SSA-44, the Medicare Income-Related Monthly Adjustment Amount Life-Changing Event form, which you submit to Social Security. Medicare & You 2027 points people to SSA.gov/medicare/lower-irmaa. You sign under penalty of perjury and provide evidence, such as a letter from your employer with your retirement date. Social Security can process your request with an estimate and ask for proof afterward.
2. Wrong or outdated tax data. You can also ask for a new determination if you filed an amended return, if the IRS corrected its information, if Social Security used a three-year-old return, or if you file separately and your living arrangement changed.
A one-time capital gain, a home sale or a Roth conversion is not a life-changing event, so it generally does not qualify.
Worked example: retiring at 65
Dave worked full time in Lincoln until December 2025, when he retired. His 2024 MAGI was $160,000, so Social Security set his 2026 Part B premium at $405.80 plus a $37.50 Part D add-on. In January 2026 he files Form SSA-44, checks "work stoppage," attaches his employer's letter, and estimates his 2026 MAGI at $70,000 (Social Security and a small pension).
Because $70,000 is under $109,000, Social Security can lower his 2026 premium to the standard $202.90 with no Part D add-on, saving $240.40 a month, or $2,884.80 for the year. One more step: his 2025 income was still high, so his 2027 premium could come back with IRMAA based on 2025. He may need to file again when that notice arrives.
How can you plan around IRMAA?
Start two years early. If you will be on Medicare in 2028, your 2026 income sets your premiums. Watch the bracket lines when deciding on Roth conversions, when to sell appreciated assets, and how much to draw from IRAs, and talk with a tax professional before you act.
If you are still working past 65, your IRMAA depends on your salary two years back; see working past 65. For the base premiums, read the Part B guide and Part D in Nebraska. For a single page of every 2026 cost, see 2026 Medicare costs at a glance.
For official answers, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week (TTY 1-877-486-2048), or Social Security at 1-800-772-1213. Nebraska SHIP (1-800-234-7119) also offers unbiased counseling. If IRMAA is changing which plan makes sense for you, talk to Bill.
Frequently asked questions
Social Security uses your modified adjusted gross income (MAGI): the adjusted gross income on your federal Form 1040 plus tax-exempt interest. It comes from the tax return filed two years before the premium year, so 2026 premiums use 2024 income. If the IRS does not have that year, Social Security uses the return from three years before, and you can ask for a new determination once the newer return is on file.
Yes. Everyone with Part B pays the Part B IRMAA if their income is over the threshold, including people in Medicare Advantage plans, because they still pay the Part B premium. If your Medicare Advantage plan includes drug coverage, you also pay the Part D IRMAA. That amount goes to Medicare, usually deducted from your Social Security, not to the plan.
Social Security recognizes eight: death of a spouse, marriage, divorce or annulment, work reduction, work stoppage, loss of income-producing property, loss of employer pension income, and receipt of a settlement payment from a current or former employer. If one of these lowered your income, you can file Form SSA-44 asking Social Security to use a more recent tax year or an estimate.
Generally no. A large capital gain, a home sale, a Roth conversion or a bigger IRA withdrawal is not one of the eight life-changing events Social Security recognizes, so it usually will not support an SSA-44 request. The higher premium normally lasts one year, since the next year's IRMAA uses a different tax return. You can still ask for a new determination if Social Security used wrong or outdated tax data.
CMS usually announces the next year's Part B premium and IRMAA amounts in November; the 2026 figures came out November 14, 2025. Medicare & You 2027 already lists the first 2027 threshold: $111,000 for individual filers and $222,000 for joint filers, based on 2025 income. The other 2027 bracket lines and surcharge amounts are not announced yet.
If you get Social Security or Railroad Retirement benefits, the Part B and Part D IRMAA amounts are usually deducted from your monthly payment along with your Part B premium. If not, Medicare bills you, monthly in that case. Pay the Part D IRMAA to Medicare or the RRB, not your plan. Medicare & You 2027 warns that if you do not pay it, you could lose your Part D coverage.
Sources
- CMS: 2026 Medicare Parts A and B premiums and deductibles (IRMAA tables) (opens in a new tab)
- Medicare & You 2027 handbook (CMS Product 10050) (opens in a new tab)
- SSA POMS HI 01101.010: Modified adjusted gross income for IRMAA (opens in a new tab)
- SSA POMS HI 01120.001: New initial IRMAA determinations (opens in a new tab)
- SSA POMS HI 01120.005: Life-changing events and Form SSA-44 (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
