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The income-related monthly adjustment amount (IRMAA) increases Medicare Part B and Part D premiums for certain high-income enrollees. It’s based on tax returns from two years prior.
IRMAA charges can apply whether you have Original Medicare or Medicare Advantage. You can appeal the Medicare IRMAA if you think a mistake was made or your circumstances have changed.
Quick links to 2026 IRMAA brackets
What is IRMAA?
The Medicare IRMAA is a surcharge on Medicare Part B (medical insurance) and Medicare Part D (prescription drug plan) premiums. It applies to people with a modified adjusted gross income above $109,000 (individual return) or $218,000 (joint return).
How is IRMAA calculated?
The Medicare IRMAA for Part B and Part D is calculated on a sliding scale based on your income. Medicare uses your modified adjusted gross income from two years ago to determine whether you have to pay the IRMAA.
What are the income limits for IRMAA?
IRMAA applies if your modified adjusted gross income from two years prior is above these levels:
- $109,000 if you’re filing individually.
- $218,000 if you’re married and filing jointly.
The 2026 IRMAA amount is based on your 2024 tax returns.
| Frequently asked questions about IRMAA | ||
|---|---|---|
| Is IRMAA based on gross income or taxable income? | Your IRMAA amount is determined based on the modified adjusted gross income (MAGI) from your tax return two years ago. | |
| Do capital gains count toward IRMAA? | Yes, since capital gains are included in MAGI, they can affect your IRMAA. | |
| Do Social Security benefits count toward IRMAA? | Yes, the taxable portion of your Social Security benefits is used to calculate your MAGI, and MAGI determines your IRMAA. | |
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Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
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- States available46 states and Washington, D.C.
- Members in high-rated plansLow (49% or less)
- Member satisfactionAbove average
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Speak to a licensed insurance agent on askchapter.org
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What are the Medicare Part B IRMAA brackets in 2026?
If the Part B IRMAA applies to you, the surcharge will be added to your Part B premium. The standard Part B premium is $202.90 per month in 2026. Depending on your income, you'll pay a total premium amount ranging from $284.10 to $689.90 in 2026.
2026 Medicare Part B IRMAA brackets
| If your income in 2024 was this ... | You'll pay this each month in 2026 | ||
| Individual tax return | Joint tax return | Married & separate tax return | Medicare Part B premium |
| Less than or equal to $109,000. | Less than or equal to $218,000. | Less than or equal to $109,000. | $202.90. |
| Greater than $109,000 and less than or equal to $137,000. | Greater than $218,000 and less than or equal to $274,000. | Not applicable. | $284.10. |
| Greater than $137,000 and less than or equal to $171,000. | Greater than $274,000 and less than or equal to $342,000. | Not applicable. | $405.80. |
| Greater than $171,000 and less than or equal to $205,000. | Greater than $342,000 and less than or equal to $410,000. | Not applicable. | $527.50. |
| Greater than $205,000 and less than $500,000. | Greater than $410,000 and less than $750,000. | Greater than $109,000 and less than $391,000. | $649.20. |
| Greater than or equal to $500,000. | Greater than or equal to $750,000. | Greater than or equal to $391,000. | $689.90. |
Medicare Part B IRMAA for immunosuppressive drug coverage only
Certain Medicare beneficiaries who aren't eligible for Medicare because they're 36 months post-kidney transplant can continue to receive Part B coverage of immunosuppressive drugs if they pay a premium. The Part B premium for immunosuppressive drugs only is $121.60 per month in 2026.
A Medicare Part B IRMAA applies to these enrollees as well if their income is above IRMAA thresholds. If this IRMAA applies to you, you'll pay a total Part B premium ranging from $202.70 to $608.10 in 2026, depending on income.
What are the Medicare Part D IRMAA brackets in 2026?
If the Medicare Part D IRMAA applies to you, you'll pay an extra $14.50 to $91 in 2026 on top of your plan premium, depending on income.
2026 Medicare Part D IRMAA brackets
| If your income in 2024 was this ... | You'll pay this each month in 2026 | ||
| Individual tax return | Married filing jointly | Married filing separately | Medicare Part D cost |
| $109,000 or less. | $218,000 or less. | $109,000 or less. | Your plan premium. |
| Above $109,000 up to $137,000. | Above $218,000 up to $274,000. | Not applicable. | $14.50 plus your plan premium. |
| Above $137,000 up to $171,000. | Above $274,000 up to $342,000. | Not applicable. | $37.50 plus your plan premium. |
| Above $171,000 up to $205,000. | Above $342,000 up to $410,000. | Not applicable. | $60.40 plus your plan premium. |
| Above $205,000 and less than $500,000. | Above $410,000 and less than $750,000. | Above $109,000 and less than $391,000. | $83.30 plus your plan premium. |
| $500,000 or above. | $750,000 or above. | $391,000 or above. | $91.00 plus your plan premium. |
💬 From our Nerds: Does IRMAA apply to Medicare Advantage plans?
“IRMAA applies to all Medicare beneficiaries whose earnings are high enough to make them eligible, even the ones on Medicare Advantage. That’s because everyone on Medicare Advantage still owes the Part B premium each month, along with any applicable IRMAA charges.
"And if you have a Medicare Advantage plan that includes prescription drug coverage, the Part D IRMAA also applies.”
— Kate Ashford, lead writer covering Medicare
» MORE: Best Medicare Advantage plans
How do I know if I have to pay the Medicare IRMAA?
When you enroll in Medicare, you'll initially pay the standard Part B premium and your Part D premium until Social Security receives your income data from the IRS. If your income is high enough for IRMAA to apply, Social Security will mail a predetermination notice.
This notice will explain that IRMAA will apply, how this determination was made and how to proceed if any of this information is in error or your situation has changed.
After sending out the predetermination notice, Social Security will mail you an initial determination notice informing you that you owe IRMAA on your Part B and Part D (if applicable) premiums. This notice also includes how the determination was made and instructions on what to do if you think it isn't correct. If you receive an initial determination notice, hang onto it and keep it in a safe place.
How do I pay the Medicare IRMAA surcharge?
If you're receiving retirement benefits from Social Security and already have your Medicare Part B and Part D (if applicable) premiums deducted from your Social Security payment, your IRMAA will automatically be deducted from your Social Security benefit.
The same applies if you receive Railroad Retirement Board benefits — your Part B IRMAA and Part D IRMAA are typically deducted from your payment.
If you don't have any Medicare premiums deducted from your Social Security payment or Railroad Retirement Board benefits, you'll receive a bill for your Part B and Part D IRMAAs.
Can I get my IRMAA reduced?
If you believe your IRMAA determination isn't correct, you've got the right to appeal. To do so, contact the Social Security Administration to request that your IRMAA determination be reconsidered. You can call 800-772-1213 to request an appeal form or fill out a Request for Reconsideration.
You don’t necessarily have to file an appeal. You can contact the SSA at 800-772-1213 and request a new look if your income has declined or if your tax return was amended. You’ll need to provide copies of documents that support your claim.
If you experienced a life event that affected your income, such as retirement or divorce, fill out the Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event form (SSA-44). You can fax or mail the form to your local Social Security office.
To qualify for a change in IRMAA determination, you'll have to show that your tax return was out of date or inaccurate for one of these reasons, according to HHS.gov:
- The IRS data contained an error.
- The IRS sent old data and you'd like them to use newer information.
- A beneficiary filed an amended tax return for the year the Social Security Administration used to make the IRMAA decision.
- Your income has recently decreased significantly due to one of these life-changing events: death of a spouse, marriage, annulment or divorce, reduction or loss of work, loss of income from income-generating property, and reduction or loss of certain types of pension income.
Does Social Security automatically adjust IRMAA?
The Social Security Administration updates your IRMAA determination each year based on your federal tax return, which is provided by the IRS. If you filed an amended tax return that would affect your IRMAA amount, contact the SSA so they can update their records.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
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- 1. Centers for Medicare & Medicaid Services. Costs. Accessed Jan 13, 2026.
- 2. Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles. Accessed Jan 13, 2026.
- 3. Centers for Medicare & Medicaid Services. Initial IRMAA Determination. Accessed Jan 13, 2026.
- 4. Centers for Medicare & Medicaid Services. Monthly premium for drug plans. Accessed Jan 13, 2026.
- 5. Social Security Administration. Request to lower an Income-Related Monthly Adjustment Amount (IRMAA). Accessed Jan 13, 2026.
- 6. Social Security Administration. Premiums: Rules for Higher-Income Beneficiaries. Accessed Jan 13, 2026.
