Medicare costs in retirement
IRMAA Brackets 2026: Medicare Premium Surcharges Explained
IRMAA is a surcharge on your Medicare premiums for higher earners, and it has sharp edges: cross a threshold by one dollar and you pay the higher premium for the entire year. Worse, the income that triggers it is from two years ago, so by the time you get the letter, the tax year is already closed.
Updated September 2026 · 8 min read
The short version
- What: the Income-Related Monthly Adjustment Amount, an extra charge added to Medicare Part B and Part D premiums when your income is above set thresholds.
- 2026 trigger: 2024 MAGI above $109,000 (single) or $218,000 (married filing jointly). Standard Part B premium is $202.90 per month.
- The lookback: 2026 premiums are set by 2024 income. Planning starts at age 63, two years before Medicare at 65.
- The cost: up to $487/month extra for Part B plus $91/month for Part D, per person. A married couple at the top tier pays nearly $13,900 per year in surcharges alone.
- The escape hatch: life-changing events (retirement, reduced hours, divorce, death of a spouse) qualify for an appeal on Form SSA-44.
What IRMAA is and how it works
Most people on Medicare pay the standard Part B premium ($202.90 per month in 2026). If your income is above certain thresholds, the Income-Related Monthly Adjustment Amount adds a surcharge to Part B and to Part D (prescription drug coverage). It is not a tax exactly, but it behaves like one: higher MAGI, higher monthly bill, deducted straight from your Social Security check or billed to you directly.
The key mechanics:
- Based on MAGI: modified adjusted gross income, which for IRMAA purposes is your AGI (Form 1040, Line 11) plus tax-exempt interest (Line 2a).
- Two-year lookback: 2026 premiums use 2024 MAGI. You cannot fix 2026 premiums with 2026 income.
- Per person: each spouse's IRMAA is determined by the couple's joint MAGI, and each pays their own surcharge. Crossing one threshold costs a married couple double.
- Recalculated annually: every year brings a new lookback year and a new determination.
The 2026 IRMAA brackets
These are the official figures CMS released on November 14, 2025. The income column is your 2024 MAGI; the premium column is what you pay monthly in 2026.
| 2024 MAGI (single) | 2024 MAGI (married filing jointly) | Part B total / mo | Part D surcharge / mo |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | +$14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | +$37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | +$60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$91.00 |
Note the Part D surcharge is added on top of whatever your Part D plan already costs, and it is paid to Medicare directly, not to your insurer. Married filing separately has a much harsher structure: above $109,000 you jump nearly to the top tier with almost no graduated middle.
The age-63 planning window
Because of the two-year lookback, the IRMAA clock starts ticking at 63, not 65. Your income in the year you turn 63 determines your very first Medicare premiums at 65. This creates a specific planning window with specific mistakes:
- Big Roth conversions at 63+: converting $100,000 at 64 can trigger two full years of IRMAA surcharges starting at 66. Price the surcharge against the conversion's tax savings before you convert.
- Selling a business or property at 64: a one-time gain can spike two years of premiums. If the sale can close at 62 instead of 63, the IRMAA years fall before Medicare starts.
- Retiring at 64 with a severance payout: the payout year often becomes the lookback year for your first Medicare premiums. An appeal (below) usually fixes this, but plan for it.
The flip side is good news for early retirees: if you retire at 60 with low income from 63 onward, your IRMAA exposure at 65 is based on those low-income years. The gap years between retirement and Medicare do double duty, keeping both ACA subsidies (before 65) and IRMAA (after 65) low.
Roth conversions vs. IRMAA: the tradeoff
Roth conversions and IRMAA pull in opposite directions. Conversions raise MAGI this year to lower taxes later; IRMAA punishes MAGI above its thresholds with higher premiums two years later. The right move depends on which cost is bigger:
- Convert aggressively before 63. Income before the lookback window never touches IRMAA. The years from retirement to 62 are the cheapest conversion years you will ever have.
- From 63 on, convert to the top of your IRMAA tier, not your tax bracket. The tier edge becomes the binding constraint. A conversion taxed at 22% that also triggers $2,300 in annual surcharges has a much higher true cost.
- RMDs will do this to you anyway. Large traditional balances produce large RMDs at 73 or 75, and RMDs count toward MAGI. Converting in your 60s to shrink future RMDs is often IRMAA-positive over a lifetime, even if it costs a surcharge year or two now.
How to appeal IRMAA
If your income has dropped since the lookback year because of a life-changing event, you can ask Social Security for a new determination using your current income instead. File Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event). Qualifying events include:
- Work stoppage or work reduction (retirement counts)
- Marriage, divorce, or annulment
- Death of a spouse
- Loss of income-producing property
You will need documentation: a letter from your employer, tax returns, or proof of the event. The classic case is retiring at 64 or 65: your premiums are initially set from peak earning years, you file SSA-44 showing retirement, and the surcharge is reduced or eliminated. File as soon as you get the initial determination notice; you can also request it proactively when you enroll.
Model IRMAA across your whole retirement
NestCalc applies IRMAA surcharges year by year using the 2-year MAGI lookback, so Roth conversions, RMDs, and capital gains all show their true lifetime cost.
Run the free calculator →Frequently asked questions
What income triggers IRMAA in 2026?
IRMAA applies in 2026 when your 2024 MAGI exceeded $109,000 (single) or $218,000 (married filing jointly). These are the official CMS thresholds released November 14, 2025.
How far back does IRMAA look at income?
Two years. Your 2026 Medicare premiums are based on the MAGI from your 2024 tax return. This is why income management starting at age 63 matters: your earnings at 63 set your premiums at 65.
Do Roth conversions trigger IRMAA?
Yes. Converted amounts are ordinary income and part of your MAGI, which is what IRMAA is based on. A large conversion at 63 or later can trigger two years of surcharges, so weigh the conversion tax savings against the IRMAA cost.
Can you appeal IRMAA?
Yes, if you had a life-changing event such as retirement, reduced work hours, marriage, divorce, or death of a spouse. File Form SSA-44 with Social Security to request a new initial determination based on your current lower income.
Does IRMAA apply to Medicare Advantage?
Yes. IRMAA surcharges apply to Part B regardless of whether you have Traditional Medicare or Medicare Advantage, and the Part D surcharge applies to Part D coverage under either option.
Is IRMAA a cliff or does it phase in?
It is a cliff at each tier. One dollar of MAGI over a threshold moves you into the next bracket for the full year, and the surcharge applies per person, so a married couple both on Medicare pays it twice.