Medicare IRMAA: The Income-Related Surcharge, Explained
IRMAA (the Income-Related Monthly Adjustment Amount) is an extra charge added to your Medicare Part B and Part D premiums when your income is above a threshold — $109,000 for a single filer or $218,000 for a married couple in 2026. Social Security uses your MAGI from 2024 to decide. If your income has since dropped because of a life-changing event, you can appeal.
IRMAA — the Income-Related Monthly Adjustment Amount — is an extra charge Social Security adds to your Medicare Part B and Part D premiums when your income is above a set threshold. Most people never pay it. But if you do, it can add hundreds of dollars a month, so it's worth understanding before it shows up.
How IRMAA Works
Every year, Social Security looks at your Modified Adjusted Gross Income (MAGI) — your adjusted gross income plus any tax-exempt interest — from two years back. For 2026, that means your 2024 tax return. If that number is above $109,000 (single) or $218,000 (married filing jointly), you fall into an IRMAA tier and pay a surcharge on top of the standard premium.
The surcharge applies to both parts:
- Part B IRMAA is added directly to your Part B premium.
- Part D IRMAA is billed separately by Social Security — on top of whatever your drug plan already charges.
See the full 2026 IRMAA brackets for the exact dollar amounts at each income tier, or estimate your surcharge from your income.
The Two-Year Lookback Is the Catch
Because IRMAA uses income from two years ago, a one-time spike — selling a home, a large Roth conversion, cashing out investments — can trigger a surcharge in a year when your income is actually much lower. The good news: IRMAA is recalculated every year, so it corrects itself as newer returns come in.
If Your Income Dropped, You Can Appeal
You don't always have to wait two years. If your income fell because of a qualifying life-changing event — retirement, the death of a spouse, divorce, and more — you can appeal your IRMAA with Form SSA-44 and have Social Security use your current income instead.
Where to Go Next
- 2026 IRMAA brackets — the exact surcharge at every income tier.
- IRMAA calculator — estimate your Part B and Part D surcharge.
- Life-changing events — the situations that let you appeal.
- How to appeal (Form SSA-44) — step by step.
IRMAA planning is one of the most valuable things a good agent does. If you're near a threshold, call us free — a small move can save a full tier.
Frequently Asked Questions
What income does IRMAA use?
Does IRMAA go away if my income drops?
Is IRMAA the same for Part B and Part D?
Sources
- Medicare Part B costs (IRMAA) — Medicare.gov
- Medicare premiums: Rules for higher-income beneficiaries — Social Security Administration
Talk to a local, licensed agent
Rocco DeLuca can walk you through your options — free, no pressure.