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"Understanding IRMAA: What Higher-Income Medicare Beneficiaries Need to

Understanding IRMAA: What Higher-Income Medicare Beneficiaries Need to Know for 2026

If you're planning for Medicare costs in 2026, you may have heard about something called IRMAA. For most Medicare beneficiaries, this won't apply to you. However, if you're among the approximately 8% of Medicare beneficiaries with higher incomes, understanding IRMAA could significantly impact your healthcare budgeting.

What is IRMAA?

IRMAA (Income-Related Monthly Adjustment Amount) is the Medicare surcharge that applies when a beneficiary's modified adjusted gross income exceeds certain thresholds. The surcharge is added to the standard Medicare Part B and Part D premiums.

Medicare beneficiaries who earn over $109,000 a year and who are enrolled in Medicare Part B and/or Medicare Part D pay the income-related monthly adjustment amount (IRMAA), which is a surcharge added to the Part B and Part D premiums.

The 2026 IRMAA brackets for Medicare are as follow:

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Single

Less Than $109,000 Part B Standard $202.90 Part D $0

$109,000 to $137,000 Part B $284.10 Part D $14.50

$137,000 to $171,000 Part B $405.80 Part D $37.50

$171,000 to $205,000 Part B $527.50 Part D $60.40

$205,000 to $500,000 Part B $649.20 Part D $83.80

Greater than $500,000 Part B $689.90 Part D $91.00

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Married Filing Jointly

Less Than $218,000 Part B Standard $202.90 Part D $0

$218,000 to $274,000 Part B $284.10 Part D $14.50

$274,000 to $342,000 Part B $405.80 Part D $37.50

$342,000 to $410,000 Part B $527.50 Part D $60.40

$410,000 to $750,000 Part B $649.20 Part D $83.80

Greater than $750,000 Part B $689.90 Part D $91.00

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Married - Filing Separately

Less Than $109,000 Part B Standard $202.90 Part D $0

$109,000 to $391,000 Part B $649.20 Part D $83.80

Greater than $391,000 Part B $689.90 Part D $91.00

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Key Points About IRMAA Timing

The Two-Year Look-Back Rule

IRMAA is based on your income tax returns two years prior. This means that for your 2026 Medicare premiums, your 2024 income tax return is used to determine whether you're subject to IRMAA. This is because the 2024 tax return is the most recent one the government has on file before the start of the 2026 coverage year.

The "Cliff Effect”

If your income crosses over to the next bracket by just $1, your Medicare premiums can jump significantly:

• Single filer earning $137,001 vs. $136,999: **$1,736 annual premium increase**

• Married couple where both are on Medicare: **$3,472 annual premium increase*

Good News for 2026

The Centers for Medicare & Medicaid Services (CMS) has released the 2026 IRMAA thresholds, bringing good news for Medicare beneficiaries. The IRMAA threshold increased from $106,000 in 2025 to $109,000 in 2026, representing a 2.83% increase.

Who Pays IRMAA?

Most Medicare beneficiaries do not pay IRMAA surcharges. According to the Medicare Trustees Report, about 5.1 million Medicare beneficiaries paid Part B IRMAA surcharges in 2025, amounting to about 7% of the 69 million total enrollees.

Can You Appeal IRMAA?

You can appeal IRMAA determinations if you've experienced qualifying life-changing events like retirement or divorce.

If you disagree with an IRMAA notice you've received, you can appeal it for several reasons. You have 60 days from receiving a notice to file an appeal for:

• Incorrect tax information used by the SSA

• Life-changing events such as loss of income, death of a spouse, marriage, or divorce

*For More information see blog Your Complete Guide to Successfully Appealing IRMAA in 2026*

Planning Strategies

Strategic income planning — including timing withdrawals and managing taxable income — can help reduce or potentially avoid IRMAA surcharges.

When managing your income through Roth conversions, you must watch your MAGI carefully to avoid accidentally crossing one of these IRMAA thresholds by a small amount and triggering significantly higher Medicare premiums.

How IRMAA is Calculated and Paid

IRMAA is calculated every year. That means if your income is higher or lower year after year, your IRMAA status can change.

• **Part B IRMAA** is automatically added to your monthly premium bill

• **Part D IRMAA** must be paid directly to Medicare—not your plan or employer. It's your responsibility to pay it even if your employer or a third party pays your Part D plan premiums.

Need Help Understanding Your Options?

Medicare planning can be complex, especially when IRMAA considerations come into play. If you have questions about how IRMAA might affect your specific situation or want to understand all Medicare options available to you, consider speaking with a licensed insurance professional.

For agent use only. Not affiliated with the U.S. federal government or federal Medicare program. This information is provided for educational purposes only and does not constitute marketing of any specific Medicare plan. *For official Medicare information, please visit Medicare.gov or call 1-800-MEDICARE. You can also contact your local State Health Insurance Program (SHIP) for personalized assistance.*

• This information is for educational purposes only and does not constitute marketing of any specific Medicare plan. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. This material is not affiliated with or endorsed by the federal Medicare program.