Medicare IRMAA in 2026
IRMAA — the Income-Related Monthly Adjustment Amount — is a surcharge Medicare adds to your Part B and Part D premiums when your income was high two years ago. For 2026, the line is drawn at $109,000 MAGI (single) / $218,000 (joint), based on your 2024 tax return. Cross it and you pay $81.20 to $487.00 extra a month on Part B, plus $14.50 to $91.00 on Part D — on top of the standard $202.90 Part B premium.
The 2026 tiers (official CMS figures)
| Single MAGI (2024) | Joint MAGI (2024) | Part B total | Part D add-on |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0 |
| $109k–$137k | $218k–$274k | $284.10 | $14.50 |
| $137k–$171k | $274k–$342k | $405.80 | $37.50 |
| $171k–$205k | $342k–$410k | $527.50 | $60.40 |
| $205k–$500k | $410k–$750k | $649.20 | $83.30 |
| ≥ $500,000 | ≥ $750,000 | $689.90 | $91.00 |
The IRMAA calculator applies these tiers to your exact number.
Why the two-year lag matters
Because 2026 premiums use 2024 income, the surcharge is a delayed echo of a year you may already have moved past. That lag is also your best planning tool: a large one-time spike in 2026 — a Roth conversion, a home sale gain, an inherited IRA payout — will raise your Medicare premiums in 2028, two years from now. Spreading such income across two calendar years, or converting in chunks that stay under the tier boundaries, can keep a one-year event from costing you two years of surcharges.
Who actually pays it
Roughly 8% of beneficiaries. It applies per person — a joint filer couple in the top tier pays roughly $1,156 a month extra combined. Married couples who file separately face a much tighter line: the surcharge tier starts at just $109,000 for each spouse, so separate filing almost always makes IRMAA worse.
When you can appeal
If 2024 was a bad income year but 2026 is not, file Form SSA-44: a home sale, an inherited IRA distribution, a Roth conversion, or the end of a pension or unemployment check are all accepted reasons to recalculate using current-year income. Retirees who simply had two strong pre-retirement years can also appeal after their income drops.
The connection to other calculators
IRMAA is the hidden cost of big income events — which is why the Roth conversion calculator and the home sale calculator both mention it. Check your projected tier with the IRMAA calculator before converting, selling, or taking a large IRA distribution.