IRMAA Brackets for 2026

IRMAA — the Income-Related Monthly Adjustment Amount — is the surcharge added to Medicare Part B and Part D premiums for higher-income beneficiaries. It has two features that make it worth understanding rather than just paying: it is calculated from income two years old, and it is a cliff.

The 2026 brackets

Thresholds and the standard premium as announced by the Centers for Medicare & Medicaid Services on 14 November 2025 for calendar year 2026. Amounts are per person — a married couple where both are enrolled pays these premiums twice. Part D surcharges are separate and are added to whatever your drug plan charges, ranging from roughly $14.50 to $91.00 per month across the same tiers. Tier premiums follow the statutory structure in which a beneficiary pays 35%, 50%, 65%, 80% or 85% of total Part B cost against the standard 25%. These figures change every autumn — confirm the current year at medicare.gov before planning around them.

The two-year lookback

Your 2026 premium is set by the income on your 2024 tax return. Not last year's income, and not this year's.

That lag cuts both ways. It means an income spike you have already forgotten — a property sale, a large conversion, an inherited IRA distribution — arrives as a premium increase two years later, long after the money is spent. It also means every planning decision you make this year is setting a premium you will pay in two years' time, which is the only reason planning works at all.

The practical version: decisions made in a given year are already locked for that year's premium impact. If you are looking at a surcharge notice now, the lever was two years ago. If you want to affect the premium two years from now, the lever is this December.

MAGI includes something people forget

For IRMAA, modified adjusted gross income is adjusted gross income plus tax-exempt interest.

Municipal bond interest counts. So do tax-exempt dividends. Which produces a genuinely irritating outcome: a retiree who deliberately structured income into municipal bonds to reduce federal tax can find that same interest pushing them over an IRMAA threshold, because the add-back does not care that the income is not taxable.

It is worth checking your own return's line 2a before assuming you are comfortably under a threshold.

The cliff, and why it matters more than the amount

Every threshold is a hard edge. One dollar over and the full surcharge for that tier applies — to Part B and Part D, for the whole year, for each enrolled spouse.

The consequence is that the marginal cost of the last dollar of income near a threshold is enormous. Crossing the first threshold by a single dollar costs a married couple where both are on Medicare well over two thousand dollars across the year in Part B alone. There is no version of the tax code where that dollar was worth earning.

Which makes the planning question narrow and answerable: where does my MAGI land relative to the nearest threshold, and can I move it under? Not "how do I minimise income," just "am I about to cross a line for nothing."

The levers, in order of usefulness

Spread Roth conversions. A large one-block conversion is the most common IRMAA trigger among planners' clients. Converting the same total across several years, each sized to stop below a threshold, achieves the same result without the surcharge. Our conversion guide covers sizing.

Use qualified charitable distributions. A QCD satisfies your RMD without the money ever becoming income — which is strictly better than a deduction here, because IRMAA reads MAGI rather than taxable income. For a charitably inclined retiree near a threshold, this is the cleanest lever available.

Time large capital gains. A property sale or concentrated position unwind lands in one year by default. Splitting it, or timing it into a year already above a threshold rather than one just below, can save a tier.

Watch the annuity events. Annuitizing a contract, a botched 1035 exchange that becomes taxable, or a large surrender all generate ordinary income in a single year. These are exactly the sort of one-time, controllable events that should be checked against the thresholds before execution rather than after.

Appealing with Form SSA-44

If a life-changing event has reduced your income since the year being measured, you can ask Social Security to use more recent figures. Qualifying events include marriage, divorce or annulment, death of a spouse, work stoppage or reduction, loss of income-producing property, loss of a pension, and certain employer settlement payments.

File Form SSA-44 with documentation — a death certificate, a letter confirming retirement, or a similar record. Note what does not qualify: simply having lower income this year without one of the listed events. The two-year lag is the design rather than an error, and appeals that argue only "my income is lower now" generally fail.

Retirement itself does qualify as a work stoppage, which makes the first year or two of retirement a common and successful appeal — and one many people never file because they assume the premium is fixed.

About the Author

Connor Cedro

Connor is the founder of Palm Wealth Capital, an independent retirement and annuity research firm based in Tampa, Florida. He holds a Finance degree (SMU '21) and an MBA ('25), and writes about annuities and retirement income planning with a focus on independent, jargon-free analysis.