Understand My Medicare

IRMAA: The Medicare Income Surcharge

What Is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s a surcharge on your Part B (and Part D) premiums if your income exceeds certain thresholds.

In plain language: if you make more money, Medicare charges you more.

How It Works

IRMAA is based on your Modified Adjusted Gross Income (MAGI) from your tax return two years prior. So your 2026 IRMAA is based on your 2024 tax return.

This two-year lookback catches people off guard. A big income year from selling a house, taking a large IRA distribution, or converting a Roth IRA will affect your Medicare premiums two years later.

2026 IRMAA Brackets

Individual MAGI (2024) Couple MAGI (2024) Monthly Part B Premium
$106,000 or less $212,000 or less $202.90
$106,001 - $133,000 $212,001 - $266,000 $284.00
$133,001 - $167,000 $266,001 - $334,000 $405.30
$167,001 - $200,000 $334,001 - $400,000 $526.50
$200,001 - $500,000 $400,001 - $750,000 $647.80
Above $500,000 Above $750,000 $769.10

Life-Changing Events

If your income dropped significantly due to certain life-changing events, you can request that Social Security use a more recent year’s income instead. Qualifying events include:

  • Marriage, divorce, or death of a spouse
  • Work stoppage or reduction
  • Loss of income-producing property
  • Loss of pension income

You’ll file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event) with Social Security.

IRMAA Planning

For higher-income retirees, IRMAA is worth planning around. Small changes in income can push you into a higher bracket. Common strategies include:

  • Timing Roth conversions to avoid crossing bracket thresholds
  • Managing capital gains across tax years
  • Coordinating retirement income sources (Social Security, pensions, IRA withdrawals)

This is where the CRPC (Chartered Retirement Planning Counselor) designation matters. Medicare premiums are part of your retirement income picture, not separate from it.

For the current bracket thresholds and premium amounts, see our Resources page.