Medicare IRMAA Surcharges Explained: Income Brackets, Appeals, and How to Reduce Them

IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B and Part D premiums if your income is above certain levels. High earners pay more for Medicare because IRMAA increases their monthly costs.

IRMAA is based on your modified adjusted gross income from two years ago. If your income has dropped due to retirement or another life-changing event, you may be able to appeal and reduce your surcharge. This guide explains how IRMAA works, the 2026 income brackets, and how to lower or appeal your IRMAA charges.

What Is IRMAA?

IRMAA is a surcharge that Medicare adds to your Part B and Part D premiums if your income exceeds certain thresholds. The surcharge is calculated using your modified adjusted gross income, or MAGI. MAGI includes your adjusted gross income plus tax-exempt interest.

Social Security uses your tax return from two years ago to determine your IRMAA. For 2026 premiums, they look at your 2024 tax return. If you did not file taxes, Social Security may use information from the IRS or ask you to provide income details.

IRMAA applies to both Original Medicare and Medicare Advantage. If you have Medicare Advantage with drug coverage, you still pay IRMAA on both Part B and Part D. The surcharge is added to your standard premium each month.

2026 IRMAA Income Brackets and Surcharges

IRMAA brackets are set by Medicare each year. For 2026, the surcharges are based on your 2024 income. The brackets differ for single filers and married couples filing jointly.

Part B IRMAA for 2026

The standard Part B premium for 2026 is $185 per month. If your 2024 income was above $106,000 for individuals or $212,000 for married couples, you pay the standard premium plus an IRMAA surcharge.

Here are the 2026 Part B IRMAA brackets and total monthly premiums.

• $106,000 or less (individual) or $212,000 or less (joint): $185 per month
• $106,001 to $133,000 (individual) or $212,001 to $266,000 (joint): $259 per month
• $133,001 to $167,000 (individual) or $266,001 to $334,000 (joint): $370 per month
• $167,001 to $200,000 (individual) or $334,001 to $400,000 (joint): $480.90 per month
• $200,001 to $500,000 (individual) or $400,001 to $750,000 (joint): $554.90 per month
• Above $500,000 (individual) or above $750,000 (joint): $628.90 per month

Part D IRMAA for 2026

Part D IRMAA is added to your prescription drug plan premium. The surcharge amount depends on your income bracket. Here are the 2026 Part D IRMAA surcharges.

• $106,000 or less (individual) or $212,000 or less (joint): $0 surcharge
• $106,001 to $133,000 (individual) or $212,001 to $266,000 (joint): $13.70 surcharge
• $133,001 to $167,000 (individual) or $266,001 to $334,000 (joint): $35.30 surcharge
• $167,001 to $200,000 (individual) or $334,001 to $400,000 (joint): $56.90 surcharge
• $200,001 to $500,000 (individual) or $400,001 to $750,000 (joint): $78.50 surcharge
• Above $500,000 (individual) or above $750,000 (joint): $85.80 surcharge

How MAGI Is Calculated

Modified adjusted gross income is your adjusted gross income from your tax return plus tax-exempt interest. This is the number Social Security uses to determine your IRMAA bracket.

MAGI includes income from wages, self-employment, pensions, Social Security benefits, capital gains, dividends, rental income, and other sources. It also includes tax-exempt interest from municipal bonds.

MAGI does not include Roth IRA distributions, qualified charitable distributions, or certain other tax-free income. Work with a tax advisor to understand how your income sources affect your MAGI and IRMAA.

How to Appeal Your IRMAA Determination

You can appeal your IRMAA determination if you had a life-changing event that reduced your income. Social Security will consider an appeal if you experienced one of the following events.

• Marriage or divorce
• Death of a spouse
• Work stoppage or reduction in hours
• Loss of income-producing property due to disaster or other event
• Loss of pension income
• Settlement payment from an employer or former employer affecting work or health benefits

How to File an Appeal

To appeal your IRMAA, complete Form SSA-44, the Medicare Income-Related Monthly Adjustment Amount Life-Changing Event form. You can download the form from the Social Security website or request it by calling Social Security.

You must file the appeal within 60 days of receiving your IRMAA determination notice. Include documentation of your life-changing event and proof of your current income, such as recent tax returns, W-2 forms, or pay stubs.

Social Security will review your appeal and send you a decision in writing. If approved, your IRMAA will be adjusted based on your updated income information. If denied, you can request a formal hearing.

Strategies to Reduce IRMAA

The best way to reduce IRMAA is to lower your modified adjusted gross income. Here are strategies that may help.

Contribute to Tax-Deferred Retirement Accounts

If you are still working, contribute to a traditional 401(k) or traditional IRA. Contributions reduce your taxable income and lower your MAGI. The contribution limits for 2026 are $23,500 for 401(k) plans and $7,000 for IRAs, with additional catch-up contributions allowed for people over 50.

Make Qualified Charitable Distributions

If you are age 70 and a half or older, you can make qualified charitable distributions from your IRA directly to a charity. These distributions count toward your required minimum distributions but do not count as taxable income. This can reduce your MAGI and lower your IRMAA.

Time Income and Deductions

If you have control over when you receive income, consider timing it to avoid IRMAA. For example, delay selling investments with large capital gains or spread them across multiple years. You can also time tax deductions to offset income in years when you are close to an IRMAA threshold.

Use Roth Conversions Strategically

Roth IRA conversions increase your income in the year you convert, which can trigger IRMAA. However, Roth distributions in future years are tax-free and do not count toward MAGI. Consider converting in years when your income is lower to avoid IRMAA in later years.

Maximize Tax Deductions

Take advantage of all available tax deductions to lower your adjusted gross income. This includes deductions for medical expenses, state and local taxes, mortgage interest, and business expenses if you are self-employed. Lowering your AGI directly reduces your MAGI.

Work with a Financial Advisor

IRMAA planning can be complex. Work with a financial advisor or tax professional who understands Medicare and tax planning. They can help you create a strategy to minimize IRMAA while meeting your financial goals.

When IRMAA Is Assessed

Social Security sends IRMAA determination notices in late fall, usually in November or December. The notice tells you if you will owe IRMAA for the following year, how much you will pay, and how to appeal.

Your IRMAA is recalculated each year based on your income from two years prior. If your income changes, your IRMAA may go up or down. Always check your notice and appeal if you believe the determination is incorrect.

How IRMAA Is Paid

Your IRMAA surcharge is added to your Part B and Part D premiums. If you receive Social Security benefits, the total amount is deducted from your monthly check. If you do not receive Social Security, Medicare will bill you directly each month.

If you have a Medicare Advantage plan with drug coverage, you pay the Part D IRMAA surcharge separately from your plan premium. The surcharge goes to Medicare, not the insurance company.

Key Takeaways

IRMAA is a surcharge on Medicare Part B and Part D premiums for people with incomes above $106,000 for individuals or $212,000 for married couples. The surcharge is based on your modified adjusted gross income from two years ago.

You can appeal your IRMAA if you had a life-changing event that reduced your income. File Form SSA-44 within 60 days of receiving your determination notice and include supporting documentation.

To reduce IRMAA, lower your MAGI by contributing to retirement accounts, making qualified charitable distributions, timing income and deductions, and maximizing tax deductions. Work with a financial advisor to create a long-term strategy to minimize IRMAA and protect your retirement income.