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 |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 - $137,000 | $218,001 - $274,000 | $284.10 |
| $137,001 - $171,000 | $274,001 - $342,000 | $405.80 |
| $171,001 - $205,000 | $342,001 - $410,000 | $527.50 |
| $205,001 - $500,000 | $410,001 - $750,000 | $649.20 |
| Above $500,000 | Above $750,000 | $689.90 |
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. Attach evidence of the event, such as a death certificate, divorce decree, or a letter from a former employer, so Social Security can use the lower, more recent income figure.
How You Find Out and How You Pay
Social Security, not Medicare, decides whether IRMAA applies and at what level. It pulls your MAGI from the IRS and mails you a predetermination or initial determination notice if a surcharge applies. The Part B portion is typically deducted from your Social Security benefit (or billed directly if you don’t yet collect benefits), while the Part D portion is billed separately even if your drug plan premium is paid to a private insurer.
If you think the determination is wrong, you can appeal. The fastest path for a qualifying drop in income is Form SSA-44; if your issue is a data error (for example, an amended return or a corrected IRS figure), you can request a new initial determination or file a formal reconsideration 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.
Sources
- SSA, “Medicare Premiums: Rules for Higher-Income Beneficiaries” (Publication No. 05-10536). Social Security’s official explanation of IRMAA, the MAGI two-year lookback, how Part B and Part D surcharges are determined, and the income thresholds.
- SSA, “Request to lower an Income-Related Monthly Adjustment Amount (IRMAA)”. Official guidance on qualifying life-changing events and how to ask Social Security to use a more recent year’s income.
- SSA, “Form SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event”. The form and instructions for requesting an IRMAA reduction after a life-changing event.
- CMS, “2026 Medicare Parts A & B Premiums and Deductibles”. Source for the 2026 standard Part B premium that IRMAA surcharges are added on top of.
Source credit, corrections, and removal requests
This article is educational Medicare commentary, not medical, legal, tax, or benefits advice. SSA and CMS sources are weighted above news or marketing commentary for IRMAA rules, thresholds, and the appeal process. If you represent a cited source and want a correction, credit change, or removal review, contact Understand My Medicare through the public contact page: https://understandmymedicare.org/contact/.