Medicare IRMAA Explained: 2026 Brackets
How Medicare IRMAA surcharges work in 2026, the income cliffs based on your 2024 MAGI, and how a single dollar over a threshold triggers the full surcharge.
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums when your modified adjusted gross income exceeds a threshold. In 2026 the first surcharge tier begins above 109,000 dollars single or 218,000 married filing jointly. The standard 2026 Part B premium is 202.90 dollars per month per person, before any IRMAA.
What IRMAA is
IRMAA is not a separate tax. It is an add-on to the standard Medicare Part B premium and a separate add-on to your Part D drug plan premium, applied per person, month by month, whenever your income exceeds a bracket threshold.
The 2-year lookback
Social Security uses your most recently available tax return to set IRMAA, which is a two-year lookback. Your 2026 IRMAA is based on the modified AGI reported on your 2024 tax return. Income you earn in 2026 shows up in 2028 IRMAA.
The 2026 first cliff
For 2026 the first IRMAA tier applies when 2024 MAGI is above 109,000 dollars single or 218,000 married filing jointly. Higher tiers stack above that, with the highest tier well above 500,000 dollars single. The full 2026 table is published by CMS.
It is a cliff, not a phase-in
One dollar over a threshold triggers the full surcharge for the entire year, for each person on Medicare. A married couple both on Medicare can pay a combined 24 extra premium payments a year because of a single dollar of extra income two years back.
How to plan around it
Because IRMAA is driven by MAGI, the levers that move MAGI matter: the size and timing of Roth conversions, QCDs to keep RMDs out of AGI, capital gains harvested in years before Medicare starts, and coordinating a large one-time distribution into a single year rather than spreading it across cliffs.
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Sources
Last reviewed . Educational estimates only; local conditions and codes take precedence. Consult a qualified professional for site-specific decisions.