Quick answer: most people pay the standard Part B premium, which is $202.90 a month in 2026. People whose modified adjusted gross income from two years earlier was above $109,000 (single) or $218,000 (married filing jointly) also pay an income-related monthly adjustment amount, or IRMAA. In 2026 that adds $81.20 to $487.00 a month to Part B and $14.50 to $91.00 a month to Part D, according to the Social Security Administration. If your income has dropped because of a life-changing event such as retirement, you can ask Social Security to use a more recent year.
Medicare premiums surprise a lot of new retirees. Many expect Part B to cost the same for everyone, then find a letter from Social Security announcing a higher amount based on a tax return filed two years earlier. That higher amount is IRMAA, and it applies to both Part B and Part D.
This guide explains the standard premiums, how IRMAA is calculated, the 2026 income brackets, why a two-year-old tax return is used, how to request a new determination when your income falls, and practical points for planning. It sits within our complete Medicare guide, which covers enrollment and plan choices in more depth. For a primer on the parts themselves, see Medicare Parts A, B, C and D explained.
Figures below come from the Social Security Administration’s 2026 Medicare premiums page, the CMS 2026 premium fact sheet and Medicare.gov, checked October 2026. This is general information, not tax or financial advice.
Standard Medicare Premiums in 2026
Before looking at IRMAA, it helps to know what most people pay.
Part A
Most people pay no premium for Part A because they or a spouse paid Medicare taxes for at least 10 years. People who do not qualify can buy Part A; Medicare.gov lists the 2026 monthly premium as $311 or $565, depending on how long the person or spouse worked and paid Medicare taxes. IRMAA does not apply to Part A.
Part B
The CMS 2026 premium fact sheet sets the standard Part B premium at $202.90 a month, up $17.90 from $185.00 in 2025, and the Part B deductible at $283. The Part B premium is charged every month whether or not you use services. Deductibles, coinsurance and copays come on top of premiums; our explainer on deductibles, copays and coinsurance covers how those cost-sharing terms work.
Part D and Medicare Advantage
Drug plan premiums vary by plan, and some plans charge none. Medicare Advantage plans also set their own premiums, and members still pay the Part B premium. IRMAA for drug coverage is added on top of the plan premium for people above the income thresholds, including people whose drug coverage comes through a Medicare Advantage plan.
What IRMAA Is and How It Is Calculated
IRMAA stands for income-related monthly adjustment amount. It is an extra charge that people with higher incomes pay for Part B and Part D coverage.
Why it exists
Under federal law, the standard Part B premium covers about a quarter of the program’s average cost per person, and general federal revenue pays the rest. People with higher incomes pay a larger share through IRMAA. The Part D adjustment works in a similar way. CMS estimates that roughly 8% of people with Part D pay the Part D income-related amounts.
Which income counts
Social Security uses modified adjusted gross income (MAGI) from your federal tax return. For IRMAA, MAGI is your adjusted gross income plus tax-exempt interest income. Social Security receives this information from the IRS.
The two-year lookback
Premiums for a given year are based on the tax return from two years earlier. For 2026, Social Security generally uses your 2024 return. If that return is not available, it may use the return from three years earlier and update the amount once the newer return is processed.
That lag explains why IRMAA often catches people in their first year or two of retirement. A final year of full salary, a large bonus, a big capital gain, a Roth conversion or a large retirement account withdrawal can push MAGI over a threshold, and the higher premium appears two years later.
The 2026 IRMAA Brackets
The Social Security Administration’s 2026 premium table lists these amounts for people who file individual returns or married couples who file jointly:
| 2024 MAGI, individual return | 2024 MAGI, joint return | Part B monthly premium | Part D add-on |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 (standard) | Plan premium only |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $202.90 + $81.20 | Plan premium + $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $202.90 + $202.90 | Plan premium + $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $202.90 + $324.60 | Plan premium + $60.40 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $202.90 + $446.30 | Plan premium + $83.30 |
| $500,000 or more | $750,000 or more | $202.90 + $487.00 | Plan premium + $91.00 |
Cliffs, not slopes
IRMAA brackets work like cliffs. Going one dollar over a threshold moves you into the next bracket for the entire year. A small change in income near a threshold can therefore change the yearly premium noticeably.
Married filing separately
People who are married, lived with their spouse at any time during the year and file separate returns face a different, steeper set of brackets, with fewer tiers. Social Security’s premium page lists those amounts.
How it applies to couples
Each spouse on Medicare pays their own Part B premium and their own IRMAA. For a couple filing jointly, both spouses on Medicare would each pay the surcharge for the bracket that matches their joint MAGI.
A Simple Illustration of the Cliff Effect
A hypothetical example shows why the brackets matter. The numbers below come straight from the 2026 table above; the people are invented for illustration only.
Imagine two single filers who each have Part B and a drug plan. One had 2024 MAGI of $108,000. The other had $110,000, just $2,000 more.
- The first person pays the standard Part B premium of $202.90 a month and only the drug plan’s own premium.
- The second person crosses the $109,000 threshold, so Part B rises to $284.10 a month ($202.90 plus $81.20), and $14.50 a month is added for Part D.
- Over 12 months, the second person pays $1,148.40 more in combined surcharges, even though their income was only $2,000 higher.
Results like this are why people near a threshold often review their income timing with a tax professional. They are also why it is worth checking the MAGI figure on your IRMAA notice, because a small error can make a real difference.
When the effect reverses
The cliff works in both directions. If income in a later tax year falls back below a threshold, the surcharge drops or ends when Social Security processes that newer return. Someone who paid IRMAA because of a one-time sale, for example, will often see their premium return to the standard amount two years later, without filing anything.
How IRMAA Is Paid
People who receive Social Security benefits usually have the Part B premium, including any IRMAA, deducted from their monthly payment. Others receive a bill from Medicare and can pay online, by mail or through automatic deduction from a bank account.
Part D IRMAA works differently from the plan premium. According to CMS, regardless of how you pay your drug plan premium, the Part D income-related amount is deducted from Social Security benefits or paid directly to Medicare, not to the plan. Missing IRMAA payments can lead to losing drug coverage, so watch for bills if the amount is not withheld from benefits.
The notice you receive
Social Security sends a letter explaining the IRMAA determination, the tax year used and how to appeal. Keep it with your Medicare paperwork, and check the income figure against your tax return.
Lowering IRMAA After a Life-Changing Event
IRMAA is based on old information, so Social Security lets people ask for a new determination when income falls for certain reasons. The request is made on form SSA-44, “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event,” or by contacting Social Security.
Qualifying events
Social Security recognizes these life-changing events:
- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage
- Work reduction
- Loss of income-producing property, when the loss was not within your control
- Loss or reduction of certain kinds of pension income
- Receipt of an employer settlement payment due to an employer’s closure, bankruptcy or reorganization
Retirement counts as a work stoppage, which makes this the most common route for new retirees. You provide an estimate of your current-year MAGI and evidence of the event, such as a letter from an employer confirming your retirement date.
What does not count
Higher income from one-time events that are not on the list, such as selling a home, a large capital gain or a Roth conversion, is not a life-changing event. In those cases the IRMAA usually stands for that year, and it ends once your income falls below the threshold in a later tax year.
Correcting errors
If the tax information Social Security used was wrong, or you filed an amended return, you can ask for a new determination with proof. Social Security’s premium page notes that if you disagree with the MAGI the IRS provided, you must correct it with the IRS. You can also appeal an IRMAA decision by requesting reconsideration.
Planning Points to Discuss With a Professional
Because IRMAA follows tax-return income, some people plan income timing with an accountant or financial planner. This article does not give tax or investment advice, but these are the kinds of topics people commonly raise:
- Timing large income events. A big withdrawal, asset sale or Roth conversion in the years just before or after 65 can affect premiums two years later.
- Watching thresholds. Because the brackets are cliffs, knowing how close you are to a threshold can matter when deciding on income timing.
- Tax-exempt interest. It counts toward IRMAA MAGI, even though it may not be taxed.
- Required minimum distributions. Required withdrawals from retirement accounts add to income in later years and can affect brackets.
- Filing status changes. Marriage, divorce or the death of a spouse can change which brackets apply.
Help with premiums at lower incomes
At the other end of the scale, people with limited income and resources may qualify for help paying premiums. State-run Medicare Savings Programs can pay the Part B premium and sometimes other costs, and Extra Help lowers Part D costs. Our guide on when to sign up for Medicare explains enrollment timing, which also affects premiums because late enrollment penalties are added on top of standard and IRMAA amounts. For a general overview of how insurers set prices outside Medicare, see what factors determine your insurance premium.
FAQ
Frequently Asked Questions
What is the Part B premium in 2026?
The standard Part B premium is $202.90 a month in 2026, according to CMS. People with higher incomes pay more through IRMAA.
What income triggers IRMAA in 2026?
For 2026, IRMAA applies when 2024 modified adjusted gross income was above $109,000 on an individual return or above $218,000 on a joint return, according to the Social Security Administration.
Why is my 2026 premium based on my 2024 income?
Social Security uses the most recent tax return the IRS provides, which is usually from two years earlier. If your income has since dropped because of a qualifying life-changing event, you can ask for a new determination.
Can I appeal IRMAA?
Yes. You can request a new determination after a life-changing event using form SSA-44, ask Social Security to correct wrong tax information, or request reconsideration of the decision.
Does IRMAA apply to Medicare Advantage members?
Yes. Medicare Advantage members pay the Part B premium, including any IRMAA, and the Part D income-related amount applies if the plan includes drug coverage.
Is IRMAA permanent?
No. It is recalculated each year based on newer tax information, so it can go up, go down or end as your income changes. N: This article is general information only and is not tax, financial or insurance advice. Confirm your premiums and options with the Social Security Administration, Medicare.gov or a qualified tax professional.
