IRMAA calculator: will my income raise my Medicare premiums in 2026?
Short answer: Medicare uses your income from two years earlier. For 2026 premiums that is your 2024 tax return. If modified adjusted gross income was over $218,000 for a married couple ($109,000 single), each person pays a surcharge on Part B and Part D, from about $1,148 to about $6,936 a year per person.
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2026 IRMAA brackets
Based on 2024 income. Premium amounts are monthly, per person; the last column is yearly.
| Married filing jointly | Single | Part B premium | Part D surcharge | Extra per person per year |
|---|---|---|---|---|
| $218,000 or less | $109,000 or less | $202.90 | $0.00 | $0 |
| Over $218,000 to $274,000 | Over $109,000 to $137,000 | $284.10 | $14.50 | $1,148 |
| Over $274,000 to $342,000 | Over $137,000 to $171,000 | $405.80 | $37.50 | $2,885 |
| Over $342,000 to $410,000 | Over $171,000 to $205,000 | $527.50 | $60.40 | $4,620 |
| Over $410,000 to $749,999 | Over $205,000 to $499,999 | $649.20 | $83.30 | $6,355 |
| $750,000 or more | $500,000 or more | $689.90 | $91.00 | $6,936 |
Source: CMS, 2026 Medicare Parts A and B premiums and deductibles. The Part D surcharge is added to your plan's premium. Married filing separately has different brackets.
One dollar over costs the whole tier
IRMAA is a cliff, not a slope. Income $1 over a threshold triggers the full surcharge for that tier for the whole year. For a married couple, crossing the first line at $218,000 adds about $2,297 a year in premiums for the two of them. That is why it pays to check before a Roth conversion, a large IRA withdrawal or selling an investment with a big gain.
If your income dropped
If your income fell because of a life-changing event, such as retiring, a spouse's death, divorce or loss of pension income, you can ask Social Security to use a more recent year. File Form SSA-44 with proof of the event.
What counts as income for IRMAA
Modified adjusted gross income for IRMAA is your adjusted gross income plus tax-exempt interest. It includes IRA and 401(k) withdrawals, Roth conversions, pensions, the taxable part of Social Security and capital gains. Qualified Roth withdrawals and qualified charitable distributions from an IRA do not count.
See the whole picture
IRMAA is one more tax that hits retirees. The free Retirement Check adds Medicare surcharges into your lifetime tax estimate, year by year.
Run the free Retirement CheckCommon questions
What are the IRMAA brackets for 2026?
For 2026 the surcharges start when 2024 modified adjusted gross income is over $218,000 for married couples filing jointly or over $109,000 for single filers. The tiers continue at $274,000, $342,000, $410,000 and $750,000 joint ($137,000, $171,000, $205,000 and $500,000 single).
What is the standard Medicare Part B premium in 2026?
The standard Part B premium for 2026 is $202.90 a month. People with higher incomes pay $284.10 to $689.90 a month.
Which year of income does Medicare use?
Medicare looks back two years. 2026 premiums are based on your 2024 tax return, and 2027 premiums on your 2025 return.
Can I appeal IRMAA?
Yes. If your income dropped because of a life-changing event such as retirement or the death of a spouse, file Form SSA-44 with Social Security to have a more recent year used.
Do Roth conversions count toward IRMAA?
Yes. A Roth conversion adds to modified adjusted gross income in the year you convert, which can raise Medicare premiums two years later.
Sources
- CMS: 2026 Medicare Parts A and B premiums and deductibles
- SSA: Premiums: rules for higher-income beneficiaries
- SSA Form SSA-44: Medicare income-related monthly adjustment amount, life-changing event