Have you met IRMAA? Medicare Premium Surcharges Based on Income
Most Medicare beneficiaries pay the standard Medicare Part B premium. However, higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount (IRMAA), which adds a surcharge to both Part B and Part D premiums.
How IRMAA Is Calculated. IRMAA is based on your modified adjusted gross income (MAGI) from two years prior. For example, your 2026 IRMAA is based on your 2024 tax return. Social Security uses this income information to determine whether you owe a surcharge and in which bracket.
IRMAA Brackets. There are multiple IRMAA tiers above the standard premium. Each tier adds a set dollar amount to your monthly Part B and Part D premiums. The surcharges increase at higher income levels, with the highest tier adding several hundred dollars per month to your combined Part B and D costs.
Life-Changing Events Appeal. If your income has significantly decreased since the tax year used for the IRMAA determination—due to retirement, divorce, death of a spouse, or other qualifying life-changing events—you can appeal to Social Security to use more recent income information. This appeal can result in reduced surcharges immediately.
Planning Considerations. Tax planning decisions—like Roth conversions, large capital gains realizations, or required minimum distributions—can push income into higher IRMAA brackets. Understanding IRMAA thresholds in advance helps inform timing decisions around income events.
IRMAA Is Per Person. IRMAA applies individually. For married couples, each spouse's IRMAA is determined separately based on that individual's income. However, MAGI for IRMAA purposes uses your individual income, not your household income, on your tax return.
