IRMAA Brackets 2026: What Medicare Really Costs at Higher Incomes
IRMAA is the surcharge Medicare adds to your Part B and Part D premiums when your income crosses certain lines. For 2026 the first line sits at $109,000 for single filers and $218,000 for joint filers. Cross it by one dollar and your premiums jump for the whole year.
How IRMAA works
The standard Part B premium in 2026 is $202.90 a month. About 8% of Medicare beneficiaries pay more than that because of IRMAA, which stands for Income-Related Monthly Adjustment Amount.
Two rules catch people off guard. First, IRMAA uses your tax return from two years ago. Your 2026 premiums are set by your 2024 modified adjusted gross income. Second, it is a cliff, not a slope. Earning $1 over a threshold puts you in the next tier for all twelve months.
2026 IRMAA brackets: Medicare Part B
Based on your 2024 MAGI. Amounts are per person, per month.
| Single filer (2024 MAGI) | Joint filers (2024 MAGI) | Monthly Part B premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 |
| $500,000 and up | $750,000 and up | $689.90 |
2026 IRMAA brackets: Medicare Part D
The same income tiers add a surcharge on top of whatever your drug plan charges.
| Single filer (2024 MAGI) | Joint filers (2024 MAGI) | Monthly Part D add-on |
|---|---|---|
| $109,000 or less | $218,000 or less | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $83.30 |
| $500,000 and up | $750,000 and up | $91.00 |
Married filing separately has its own harsher schedule. Above $109,000 you pay the $649.20 tier immediately, and above $391,000 the top tier applies.
The $1 cliff, in real dollars
A single retiree with $109,000 of MAGI in 2024 pays $202.90 a month in 2026. At $109,001 the premium becomes $284.10 plus the $14.50 Part D add-on. That one dollar of income costs about $1,148 over the year. For a married couple where both are on Medicare, one dollar over the joint threshold costs about $2,296.
This is why retirees watch Roth conversions, capital gains, and big IRA withdrawals so carefully in the years before and during Medicare. Each of those raises MAGI, and MAGI two years later sets your premium.
The senior deduction will not save you from IRMAA
The new $6,000 senior deduction reduces your taxable income but not your AGI, because it is a below-the-line deduction. IRMAA is calculated from MAGI, which starts at AGI. So claiming the senior deduction does nothing to lower a future IRMAA surcharge. The same is true of the tips and overtime deductions. Read why below the line matters.
The one new deduction that does reduce AGI is the charitable deduction for non-itemizers, up to $1,000 single or $2,000 married. Small, but it works in the right direction.
You can appeal after a life change
If your income dropped since 2024 because of retirement, a spouse's death, divorce, or losing a pension, you do not have to accept the surcharge. File form SSA-44 with the Social Security Administration and ask them to use your current, lower income instead. Retirement is the most common successful reason. A one-time spike from a Roth conversion or a home sale does not qualify.
Frequently asked questions
What are the IRMAA brackets for 2026?
The Part B surcharge starts above $109,000 MAGI for single filers and $218,000 for joint filers, based on your 2024 tax return. Premiums run from the standard $202.90 up to $689.90 a month at the top tier. Part D adds $14.50 to $91.00 on top of your plan premium.
What income year does 2026 IRMAA use?
Your 2024 tax return. There is always a two year lookback. Your 2025 income will set your 2027 premiums, and your 2026 income sets 2028.
Is IRMAA based on AGI or taxable income?
Neither exactly. It uses MAGI, which is your AGI plus tax-exempt interest. Below-the-line deductions like the standard deduction and the new $6,000 senior deduction do not reduce it.
How do I avoid or reduce IRMAA?
Manage MAGI in the lookback year: spread Roth conversions across years, harvest gains carefully, use qualified charitable distributions from IRAs after age 70½, and stay aware of the cliff thresholds. If your income dropped due to a life event like retirement, file SSA-44 to appeal.