Medicare IRMAA Surcharges in 2026: Could Your Medicare Premiums Be Higher Than Expected?
Many retirees are surprised to discover that Medicare premiums aren't the same for everyone. If your income is above certain thresholds, you may pay significantly more — and the planning decisions you make today can affect what you pay years from now.
If your income is above certain thresholds, you may pay significantly more for both Medicare Part B and Medicare Part D through what's known as the Income-Related Monthly Adjustment Amount (IRMAA).
The good news? Understanding how IRMAA works before you retire may give you opportunities to reduce or even avoid these additional costs.
What Is IRMAA?
IRMAA is an additional premium that Medicare charges higher-income individuals.
Unlike most people assume, Medicare doesn't look at your current year's income. Instead, it generally looks at your Modified Adjusted Gross Income (MAGI) from two years earlier.
For your 2026 Medicare premiums, Social Security generally reviews your 2024 tax return to determine whether an IRMAA surcharge applies.
Who Pays IRMAA?
For 2026, you begin paying IRMAA if your 2024 Modified Adjusted Gross Income exceeded:
- ·$109,000 for single filers
- ·$218,000 for married couples filing jointly
If your income falls below these amounts, your standard Medicare Part B premium remains $202.90 per month.
How Much Can IRMAA Cost?
As income increases, so do the surcharges. For 2026, the monthly IRMAA surcharges range from:
- ·Part B: $81.20 to $487.00 per month
- ·Part D: $14.50 to $91.00 per month
For married couples filing jointly, these costs effectively double — because each spouse pays their own Medicare premiums.
2026 IRMAA Surcharge Tiers
Based on 2024 MAGI
| MFJ (2024 MAGI) | Single (2024 MAGI) | Part B Surcharge | Part D Surcharge |
|---|---|---|---|
| $218,000 or less | $109,000 or less | — | — |
| $218,001 – $274,000 | $109,001 – $137,000 | +$81.20/mo | +$14.50/mo |
| $274,001 – $342,000 | $137,001 – $171,000 | +$202.90/mo | +$37.50/mo |
| $342,001 – $410,000 | $171,001 – $205,000 | +$324.60/mo | +$60.40/mo |
| $410,001 – $749,999 | $205,001 – $499,999 | +$446.30/mo | +$83.30/mo |
| $750,000 or more | $500,000 or more | +$487.00/mo | +$91.00/mo |
Can You Appeal an IRMAA Decision?
Possibly.
If your income has dropped because of a qualifying life-changing event, you may request that Social Security reconsider your Medicare premiums. Examples include:
- ·Retirement or reduction in work hours
- ·Marriage, divorce, or death of a spouse
- ·Loss of pension income
- ·Loss of income-producing property
In many situations, you can request a new determination by filing Social Security Form SSA-44.
Planning Ahead Can Make a Difference
Many retirees unintentionally trigger higher Medicare premiums because they don't realize how certain financial decisions affect future IRMAA calculations. Examples include:
- ·Large IRA withdrawals
- ·Roth conversions
- ·Selling appreciated investments
- ·Significant capital gains
- ·Business sales
- ·Required Minimum Distributions (RMDs)
While these strategies may still make sense, understanding the timing and tax impact can help avoid unexpected Medicare costs.
The Bottom Line
IRMAA is one of those retirement expenses that often catches people off guard. The good news is that with proactive retirement income and tax planning, it's often possible to anticipate these surcharges — and in some cases, reduce or avoid them.
If you're approaching retirement or already retired, reviewing how today's tax decisions could affect your Medicare premiums in future years can be an important part of your overall retirement strategy.
Complimentary Guide
2026 Tax Cheat Sheet
All the key tax brackets, IRMAA thresholds, retirement limits, and Medicare figures for 2026 — on one page.
Written by
Tom Sweeney, ChFC®, CRPC®
Founder, TS Wealth Advisors · 30 years of experience in wealth management
Wondering whether IRMAA could increase your Medicare premiums? At TS Wealth Advisors, we help retirees coordinate their retirement income, taxes, investments, and Medicare considerations so there are fewer surprises along the way.
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