A surcharge, not a different premium
IRMAA stands for income-related monthly adjustment amount. It is an amount added to the standard Part B premium, and separately to your Part D premium, when your income is above a threshold. It is not a different plan and it is not optional.
Social Security assesses it from your modified adjusted gross income on the tax return filed two years earlier. For 2026 that means your 2024 return. This two-year lag is why people are surprised: the income that triggers the surcharge may be from a year in which their circumstances were completely different.
Where the thresholds sit for 2026
The brackets are cliffs, not slopes. A dollar over a threshold moves you into the whole next bracket.
| Individual MAGI | Joint MAGI | Total Part B premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 | Above $218,000 | Higher than standard | Added to your plan premium |
Source: CMS, 14 November 2025. Full bracket table at the source.
A life-changing event can reset it
If your income has dropped since the tax year being used, you can ask Social Security to use a more recent year. This is a formal process, not a complaint, and it exists precisely because the two-year lag misreads people whose circumstances changed.
Social Security lists the qualifying life-changing events, which include retirement or reduced work hours, the death of a spouse, marriage or divorce, and loss of income-producing property. The form is SSA-44.
Many people pay a surcharge for a year that no longer reflects their income simply because nobody told them the form exists.
2027 brackets are not out yet
CMS had not published the 2027 IRMAA brackets when this guide was last reviewed. They normally arrive with the Part B premium announcement in the autumn.
Frequently asked questions
What income triggers IRMAA in 2026?
For 2026 the first threshold is modified adjusted gross income above $109,000 for an individual or $218,000 for a couple filing jointly, measured from the 2024 tax return. Below that you pay the standard premium with no surcharge.
Why is Medicare using a tax return from two years ago?
Social Security uses the most recent return the IRS has made available, which is two years behind. If your income has fallen since then because of a life-changing event, you can ask for a more recent year to be used with form SSA-44.
Can I appeal an IRMAA decision?
Yes. If a qualifying life-changing event such as retirement, the death of a spouse, marriage or divorce reduced your income, you can file form SSA-44 with Social Security asking them to use a more recent tax year.
Does IRMAA apply to Part D as well?
Yes. The surcharge is assessed separately on Part B and Part D. The Part D amount is added to whatever your drug plan charges, and it is paid even if your plan premium itself is low.
Sources
This guide explains officially published rules and figures. It is not an insurance quote and not an eligibility determination. Only HealthCare.gov, Medicare.gov, Social Security or the carrier can determine your eligibility and your actual price.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program.
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