Medicare IRMAA 2026: Income Limits, Part B & Part D Premiums, and Appeals

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Medicare premiums are not the same for every enrollee. People with higher income may pay an additional monthly amount called the Income-Related Monthly Adjustment Amount (IRMAA).

IRMAA is not an income tax. It is an income-based surcharge added to Medicare Part B and, for people enrolled in Medicare prescription drug coverage, Part D. Your 2026 IRMAA is generally based on information from your 2024 federal tax return.

IRMAA is closely connected to retirement-income planning because Traditional IRA withdrawals, 401(k) distributions, Roth conversions, taxable investment sales, wages, and other income can affect your modified adjusted gross income. For related federal tax planning, see Is Social Security Taxed? Federal Tax Rules and Planning Considerations.

Financial planning and Medicare IRMAA premium costs

Medicare premiums can change when income reaches an IRMAA threshold.

2026 IRMAA Basics

For 2026, the standard Medicare Part B premium is $202.90 per month. IRMAA generally applies when 2024 modified adjusted gross income was more than $109,000 for an individual filer or more than $218,000 for a couple filing jointly.

1. How Medicare Calculates IRMAA

The Social Security Administration generally uses the most recent tax return information provided by the IRS. For 2026 premiums, that is usually your 2024 return, filed in 2025. If 2024 information is not yet available, SSA may use 2023 information instead.

For IRMAA purposes, modified adjusted gross income (MAGI) is generally:

Adjusted Gross Income + Tax-Exempt Interest Income

MAGI can increase when you receive wages, take pre-tax retirement-account withdrawals, complete a Roth conversion, realize taxable capital gains, receive taxable interest or dividends, or receive other taxable income. Tax-exempt municipal-bond interest is also included in the IRMAA calculation.

IRMAA works in tiers. Crossing a threshold can move you to the next premium tier for the full year, even when income exceeds the threshold by only a small amount.

2. 2026 Medicare IRMAA Income Limits and Premiums

The following table applies to people filing as single, head of household, qualifying surviving spouse, or married filing jointly. The income ranges use 2024 MAGI, unless SSA uses an earlier return because newer information is unavailable.

2024 MAGI: Individual 2024 MAGI: Married Filing Jointly 2026 Part B Monthly Premium 2026 Part D IRMAA
$109,000 or less $218,000 or less $202.90 $0, plus your plan premium
More than $109,000 to $137,000 More than $218,000 to $274,000 $284.10 $14.50, plus your plan premium
More than $137,000 to $171,000 More than $274,000 to $342,000 $405.80 $37.50, plus your plan premium
More than $171,000 to $205,000 More than $342,000 to $410,000 $527.50 $60.40, plus your plan premium
More than $205,000 and less than $500,000 More than $410,000 and less than $750,000 $649.20 $83.30, plus your plan premium
$500,000 or more $750,000 or more $689.90 $91.00, plus your plan premium

Married filing separately: If you were married and lived with your spouse during the tax year, special lower thresholds apply. For 2026, MAGI above $109,000 can result in the fourth IRMAA tier, and MAGI of $391,000 or more can result in the highest tier. Review the SSA premium chart for your exact filing situation.

3. Income Events That Can Trigger IRMAA

IRMAA can result from regular income, but it can also be triggered by one-time transactions. Review the possible effect before completing a large transaction.

  • Large Traditional IRA or 401(k) withdrawals: These are generally included in taxable income.
  • Roth conversions: A conversion is generally taxable in the conversion year, even though qualified Roth withdrawals may later be tax-free.
  • Taxable brokerage sales: Realized capital gains can increase adjusted gross income.
  • Bonus payments, severance, or part-time work: Employment income can increase MAGI.
  • Required minimum distributions: RMDs from pre-tax retirement accounts can increase income after they begin.
  • Tax-exempt interest: Municipal-bond interest may be federally tax-exempt, but it is included in IRMAA MAGI.

4. Planning Before a Major Income Event

IRMAA should be one factor in a broader retirement plan, not the only reason to avoid income. It can still make sense to take a larger withdrawal or complete a Roth conversion when the long-term tax benefit outweighs a temporary premium increase.

  • Estimate MAGI before year-end. Compare projected income with the next IRMAA threshold before completing a Roth conversion or major investment sale.
  • Spread transactions across tax years when appropriate. Multiple smaller Roth conversions or investment sales may produce a different result than one large transaction.
  • Review charitable giving options. At age 70½ or older, a properly completed Qualified Charitable Distribution can send money directly from an IRA to an eligible charity. For 2026, the annual QCD limit is $111,000 per eligible IRA owner.
  • Understand QCD requirements. The payment must move directly from the IRA custodian to an eligible charity. A QCD can generally count toward an IRA required minimum distribution when applicable, while staying out of adjusted gross income.
  • Coordinate Medicare with tax planning. Consider federal income tax, state income tax, Social Security taxation, RMDs, and expected health-care costs together.

5. How to Request a Lower IRMAA Amount

A high-income tax return from two years ago may not reflect your current circumstances. The SSA may make a new IRMAA decision when a qualifying life-changing event reduced your income.

Examples include retirement or a reduction in work, marriage, divorce, the death of a spouse, loss of income-producing property because of a disaster, certain pension-plan changes, or an employer settlement related to closure, bankruptcy, or reorganization.

Use Form SSA-44, Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event, and provide supporting documents. If you disagree with an IRMAA decision for another reason, you may request reconsideration through the SSA appeal process.

Sources and Further Reading

Last reviewed: July 2026

Educational disclaimer: This article is for general educational purposes only and is not tax, legal, insurance, investment, or financial advice. Medicare premiums, IRMAA thresholds, tax rules, and personal circumstances can change. Review current SSA, CMS, and IRS guidance and consult a qualified professional for advice about your situation.

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