The 2026 Medicare IRMAA brackets add an income-related surcharge once 2024 MAGI tops $109,000 (single) or $218,000 (joint), running across five tiers above the standard $202.90 Part B premium.
Key Takeaways
- The standard 2026 Part B premium is $202.90 per month, up 9.7 percent from $185.00 in 2025.
- IRMAA begins when 2024 MAGI exceeds $109,000 for single filers or $218,000 for married couples filing jointly.
- Five tiers add a Part B surcharge of $81.20 to $487.00 and a Part D add-on of $14.50 to $91.00 per month.
- The top tier applies at $500,000 (single) or $750,000 (joint) of 2024 MAGI and is fixed by statute.
- Because IRMAA is a cliff, crossing the first single-filer line by one dollar costs $1,148.40 for the year.
- About 4.8 million Part B enrollees paid IRMAA in 2024, a count the Trustees project to reach 10.2 million by 2035.
- 2026 IRMAA uses 2024 MAGI on a two-year lookback, and a life-changing event can be appealed on Form SSA-44.
2026 Medicare IRMAA at a glance
Thresholds use 2024 MAGI on a two-year lookback; figures reflect the sources cited above.
The 2026 Medicare IRMAA brackets add an income-related surcharge to the standard Part B and Part D premiums once a beneficiary’s 2024 modified adjusted gross income (MAGI) exceeds $109,000 for single filers or $218,000 for married couples filing jointly. This page gives the finalized 2026 thresholds, the per-tier premium amounts for every filing status, the dollar cost of crossing a bracket line, and how to appeal, all keyed to primary federal sources.
In 2026 the standard Part B premium is $202.90 per month. IRMAA begins when 2024 MAGI exceeds $109,000 (single) or $218,000 (married filing jointly). Five tiers add a Part B surcharge of $81.20 to $487.00 and a Part D add-on of $14.50 to $91.00, topping out at $500,000 (single) or $750,000 (joint). IRMAA is a cliff: one dollar over a line triggers the full tier for the year.
What is Medicare IRMAA and how does it work in 2026?
Medicare IRMAA (the Income-Related Monthly Adjustment Amount) is a surcharge added to the standard Part B and Part D premiums for higher-income beneficiaries. It was created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and took effect for Part B in 2007 and Part D in 2011 (Source: CRS R40082). In 2026 it applies across five income tiers keyed to 2024 MAGI.
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A standard enrollee pays about 25 percent of the aged actuarial cost of Part B. IRMAA tiers are set so higher earners pay 35, 50, 65, 80, or 85 percent of that cost instead (Source: 2026 Medicare Trustees Report). For the plain-language mechanics that stay the same each year, see our evergreen IRMAA surcharge explainer; this page focuses on the finalized 2026 numbers and the year-over-year change.
What are the 2026 IRMAA brackets for single, HoH, or qualifying surviving spouse?
For 2026, a single filer, head of household, or qualifying surviving spouse pays no IRMAA at or below $109,000 of 2024 MAGI. Above that, five tiers apply. The Part B column below is the total monthly premium (the $202.90 base plus the surcharge); the Part D column is the monthly IRMAA add-on paid on top of the enrollee’s own plan premium (Sources: SSA POMS HI 01101.020; Federal Register 2025-20251).
| 2024 MAGI (single/HoH/QSS) | Part B surcharge | Total Part B / month | Part D IRMAA / month |
|---|---|---|---|
| $109,000 or less | $0.00 | $202.90 | $0.00 |
| Above $109,000 to $137,000 | $81.20 | $284.10 | $14.50 |
| Above $137,000 to $171,000 | $202.90 | $405.80 | $37.50 |
| Above $171,000 to $205,000 | $324.60 | $527.50 | $60.40 |
| Above $205,000 to below $500,000 | $446.30 | $649.20 | $83.30 |
| $500,000 or more | $487.00 | $689.90 | $91.00 |
What are the 2026 IRMAA brackets for married filing jointly?
For married couples filing jointly in 2026, the income thresholds are exactly double the single-filer figures, starting above $218,000 of 2024 MAGI, but the surcharge amounts are identical per person. Each spouse enrolled in Medicare pays the surcharge separately, so a couple with both spouses on Medicare effectively pays the per-person amount twice (Source: SSA POMS HI 01101.020).
| 2024 MAGI (married filing jointly) | Part B surcharge | Total Part B / month | Part D IRMAA / month |
|---|---|---|---|
| $218,000 or less | $0.00 | $202.90 | $0.00 |
| Above $218,000 to $274,000 | $81.20 | $284.10 | $14.50 |
| Above $274,000 to $342,000 | $202.90 | $405.80 | $37.50 |
| Above $342,000 to $410,000 | $324.60 | $527.50 | $60.40 |
| Above $410,000 to below $750,000 | $446.30 | $649.20 | $83.30 |
| $750,000 or more | $487.00 | $689.90 | $91.00 |
What are the 2026 IRMAA brackets for married filing separately?
Married filing separately uses only two IRMAA tiers in 2026, mapped to the top two amount levels, so it can produce a steep surcharge at a comparatively low income (Source: SSA POMS HI 01101.020). One quirk deserves attention: the second-tier entry point of $391,000 is actually lower than the 2025 figure of $394,000. Most thresholds rose year over year; this one moved the other way.
| 2024 MAGI (married filing separately) | Total Part B / month | Part D IRMAA / month |
|---|---|---|
| $109,000 or less | $202.90 | $0.00 |
| Above $109,000 to below $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91.00 |
What is the standard Part B premium in 2026, and what changed from 2025?
The standard Part B premium in 2026 is $202.90 per month, up 9.7 percent from $185.00 in 2025, and the annual Part B deductible rose from $257 to $283 (Source: Federal Register 2025-20251; CMS 2026 fact sheet). The single-filer entry threshold rose $3,000 to $109,000 and the joint entry threshold rose $6,000 to $218,000. The top thresholds of $500,000 and $750,000 did not move.
| Single-filer tier | 2025 total Part B / mo | 2026 total Part B / mo |
|---|---|---|
| Base (no IRMAA) | $185.00 | $202.90 |
| Tier 1 | $259.00 | $284.10 |
| Tier 2 | $370.00 | $405.80 |
| Tier 3 | $480.90 | $527.50 |
| Tier 4 | $591.90 | $649.20 |
| Tier 5 (top) | $628.90 | $689.90 |
The top thresholds are fixed by statute and are not inflation-indexed, so more incomes reach them over time (Source: SSA POMS HI 01101.020).
What does going one dollar over an IRMAA bracket cost?
Because IRMAA is a cliff, crossing a bracket by a single dollar triggers the entire tier for twelve months. Q3 Advisors computes the annual cliff cost as (the Part B monthly surcharge plus the Part D monthly add-on) times twelve, for a Part D-enrolled single filer in 2026 (Sources: Federal Register 2025-20251; SSA POMS HI 01101.020). The entry-tier cliff alone is $1,148.40 per year. Related income thresholds are mapped in retirement tax cliffs for 2026.
| Crossing (single-filer MAGI) | Combined monthly surcharge | Annual cliff vs. no-IRMAA baseline |
|---|---|---|
| Above $109,000 | $95.70 | $1,148.40 |
| Above $137,000 | $240.40 | $2,884.80 |
| Above $171,000 | $385.00 | $4,620.00 |
| Above $205,000 | $529.60 | $6,355.20 |
| Above $500,000 | $578.00 | $6,936.00 |
The entry-tier cliff rose from $1,052.40 in 2025 to $1,148.40 in 2026, a 9.1 percent increase. For a couple with both spouses on Medicare, every figure roughly doubles. These cliffs are why one-time income events, such as a large capital gain or a Roth conversion, can decide which bracket applies.
What income counts toward IRMAA (MAGI) and which tax year is used?
For IRMAA, MAGI is adjusted gross income (AGI) plus tax-exempt interest income (Source: 20 CFR 418.1010). SSA sets the surcharge using MAGI from the tax year two years before the premium year, so 2026 IRMAA is based on your 2024 tax return (Source: 20 CFR 418.1135). If that data is unavailable, SSA temporarily uses the return from three years prior and corrects later.
This two-year lookback is why income you recognize now affects premiums later. Distributions from pre-tax accounts feed AGI, which makes required minimum distributions and the 3.8 percent Net Investment Income Tax part of the same planning picture as IRMAA.
How can I avoid or reduce IRMAA in 2026?
Because IRMAA keys to 2024 MAGI on a two-year lookback, avoiding an unnecessary surcharge is about managing the size and timing of taxable income two years ahead. Many retirees compare their projected MAGI to the nearest bracket line and decide whether an additional dollar of income (from a distribution, gain, or conversion) is worth the full-tier jump. IRMAA is educational context here, not personalized advice.
Strategies retirees and their advisers often weigh include:
- Spreading Roth conversion income across years to keep each year’s MAGI below the next bracket line, rather than converting a large sum in one year.
- Sizing conversions to a target bracket ceiling; our discussion of how much to convert to Roth covers the tradeoffs.
- Smoothing capital gains across tax years instead of realizing them all at once.
- Timing a conversion before the December 31 Roth conversion deadline in a lower-income year, remembering that a conversion is taxable ordinary income and cannot be reversed.
One planning note: the last conversion year that does not affect a Medicare premium is age 62, because premiums begin at 65 and use a two-year lookback. Separately, retirees can review whether Medicare premiums are tax deductible.
How do I appeal IRMAA with Form SSA-44?
You can request a New Initial Determination by filing Form SSA-44 (edition 12-2025, OMB No. 0960-0784) when a qualifying life-changing event has reduced your income (Sources: 20 CFR 418.1205; SSA POMS HI 01120.001). SSA generally accepts requests within 60 days of the initial determination notice. A reduction only changes your premium if it moves you to a lower IRMAA tier.
What counts as a life-changing event?
Form SSA-44 lists eight qualifying events: marriage; divorce or annulment; death of a spouse; work stoppage; work reduction; loss of income-producing property; loss of pension income; and an employer settlement payment (Source: SSA POMS HI 01120.005). Certain one-time income spikes do not qualify. POMS HI 01120.005 expressly excludes capital gains, lottery or casino winnings, cashing bonds, and conversion of an IRA.
How many people pay IRMAA, and what do the Trustees project through 2035?
About 4.8 million Part B enrollees paid an income-related premium in 2024, roughly 8 percent of enrollees, and the Trustees estimate 5.1 million for 2025 (Sources: 2025 and 2026 Medicare Trustees Reports). Under the Trustees’ intermediate assumptions, that count is projected to roughly double to 10.2 million by 2035, while the standard Part B premium is projected to reach $360.60. The 2027 premium is not yet finalized; CMS sets it each November.
| Year | Projected standard Part B premium | Projected IRMAA payers (millions) |
|---|---|---|
| 2025 (estimate) | $185.00 | 5.1 |
| 2026 (actual) | $202.90 | 5.4 |
| 2027 (projected) | $209.50 | 5.7 |
| 2030 (projected) | $255.50 | 7.5 |
| 2035 (projected) | $360.60 | 10.2 |
Aggregate IRMAA collections are projected to rise from $14.1 billion in 2025 to $55.8 billion in 2035 (Source: 2026 Medicare Trustees Report, Table V.E3). The Trustees also note Part D IRMAA amounts will increase more rapidly beginning in 2030 because of the Inflation Reduction Act of 2022.
The IRMAA Bracket-Creep Index: how thresholds have lagged premiums since 2007
The IRMAA Bracket-Creep Index (BCI), developed by Q3 Advisors, measures how fast the standard Part B premium has grown relative to the single-filer income threshold at which IRMAA first applies, both indexed to 2007 = 1.00. The 2026 BCI is 1.59: since 2007 the premium rose 117.0 percent (from $93.50 to $202.90) while the entry threshold rose only 36.3 percent (from $80,000 to $109,000).
The gap widened during the Affordable Care Act freeze that held the threshold at $85,000 from 2011 through 2019 while premiums kept rising (Source: CRS R40082). A common error in secondary sources is to report a flat $80,000 or $85,000 for the whole 2007 to 2019 span; the CRS R40082 primary record shows $80,000 (2007), $82,000 (2008), then $85,000 from 2009 onward.
| Year | Standard Part B premium | Single-filer entry threshold | BCI (2007 = 1.00) |
|---|---|---|---|
| 2007 | $93.50 | $80,000 | 1.00 |
| 2011 | $115.40 | $85,000 | 1.16 |
| 2019 | $135.50 | $85,000 | 1.36 |
| 2022 | $170.10 | $91,000 | 1.60 |
| 2024 | $174.70 | $103,000 | 1.45 |
| 2025 | $185.00 | $106,000 | 1.49 |
| 2026 | $202.90 | $109,000 | 1.59 |
Because a rising premium sits on top of a threshold that has climbed more slowly, identical real incomes drift into surcharge territory over time (inputs: SSA POMS HI 01001.014; CRS R40082 Table B-1; SSA POMS HI 01101.020).
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Q3 Advisors is a registered investment adviser focused on retirement tax planning. This page is educational and is not advice; consult a qualified professional.
Frequently asked questions
What are the IRMAA brackets for 2026?
The 2026 IRMAA brackets run across five tiers. For single filers they begin above $109,000 of 2024 MAGI and reach the top at $500,000; for joint filers they begin above $218,000 and top out at $750,000. The Part B surcharge ranges from $81.20 to $487.00 per month and the Part D add-on from $14.50 to $91.00 (Source: SSA POMS HI 01101.020).
What income triggers IRMAA in 2026?
IRMAA is triggered in 2026 when 2024 MAGI exceeds $109,000 for a single filer, head of household, or qualifying surviving spouse, or $218,000 for a married couple filing jointly (Source: SSA POMS HI 01101.020). MAGI equals adjusted gross income plus tax-exempt interest, and one dollar over the line triggers the full first tier.
What tax year is 2026 IRMAA based on?
2026 IRMAA is based on the MAGI reported on your 2024 federal tax return, reflecting the two-year lookback (Source: 20 CFR 418.1135; CMS 2026 fact sheet). If SSA does not have that data, it temporarily uses your 2023 return and corrects the determination once the 2024 figure is available.
Is IRMAA based on gross income or taxable income?
Neither exactly. IRMAA uses modified adjusted gross income (MAGI), which for this purpose is adjusted gross income (AGI) plus tax-exempt interest income (Source: 20 CFR 418.1010). AGI already reflects above-the-line deductions, so IRMAA is not based on total gross income and not on final taxable income after the standard or itemized deduction. Income tax brackets work from a different figure, covered in whether tax brackets are based on AGI.
Do both spouses have to pay IRMAA?
Each spouse enrolled in Medicare pays the surcharge separately. When a couple files jointly and both are on Medicare, the same joint MAGI places each spouse in the same tier, so the household effectively pays the per-person Part B surcharge and Part D add-on twice (Source: SSA POMS HI 01101.020).
What is the highest IRMAA surcharge in 2026?
The highest 2026 Part B surcharge is $487.00 per month, which brings the total Part B premium to $689.90 per month, plus a Part D IRMAA add-on of $91.00 per month (Source: SSA POMS HI 01101.020; Federal Register 2025-20251). It applies at $500,000 or more of MAGI for single filers and $750,000 or more for joint filers.
Is IRMAA a one-time charge or does it recur every year?
IRMAA recurs. SSA redetermines it each year using the most recent MAGI on file (the premium year minus two), so the surcharge continues as long as your income stays above a threshold. When income normalizes, the surcharge typically falls off two years later, once the high tax year rolls out of the lookback window (Source: 20 CFR 418.1135).
How do I avoid IRMAA in 2026?
Because 2026 IRMAA keys to 2024 MAGI, avoiding a surcharge means managing taxable income two years ahead. Many retirees spread Roth conversions across years, smooth capital gains, and watch the nearest bracket line before adding income. A qualifying life-changing event can be appealed on Form SSA-44, but routine one-time gains and IRA conversions do not qualify (Source: SSA POMS HI 01120.005).
This material is provided by Q3 Advisors, a registered investment adviser, for informational and educational purposes only. It is not investment, legal, or tax advice, nor a recommendation to buy or sell any security or to adopt any strategy. Information is believed reliable as of the dates cited, but accuracy is not guaranteed and figures are subject to change. Registration with the SEC or a state does not imply a certain level of skill or training. See Q3 Advisors’ Form ADV Part 2A for information on services, fees, and conflicts of interest. Consult your own qualified tax, legal, or financial advisor before making decisions.
