What Is IRMAA and Why It Could Raise Your Medicare Premium
How IRMAA is Calculated (The 2-Year Lookback)
The Income-Related Monthly Adjustment Amount (IRMAA) is a mandatory surcharge added to the standard Medicare Part B and Part D premiums for beneficiaries with high incomes. The Social Security Administration (SSA) determines who must pay this extra charge based on a taxpayer's Modified Adjusted Gross Income (MAGI). Your MAGI is your total adjusted gross income plus any tax-exempt interest income you reported on your federal tax return.
Because tax returns are not filed immediately, the SSA enforces a strict 2-year lookback rule to determine your IRMAA status. This means that the SSA uses the MAGI reported on your tax return from two years prior to calculate your current premium. For example, whether you must pay an IRMAA surcharge in 2026 hinges entirely on the MAGI reported on your 2024 tax return (which was filed in 2025).
2026 IRMAA Income Brackets
For 2026, the standard Medicare Part B premium is $202.90 per month. Beneficiaries whose MAGI falls below the high-earner threshold will pay this standard amount, while those exceeding the limits will pay the standard premium plus the IRMAA surcharges for both Part B and Part D.
The 2026 IRMAA thresholds are determined by your tax filing status. If your 2024 MAGI was $109,000 or less as an individual, or $218,000 or less as a married couple filing jointly, you will not pay an IRMAA surcharge. If your income exceeds those amounts, you fall into one of five IRMAA penalty tiers.
| 2026 MAGI (Single Filer) | 2026 MAGI (Married Jointly) | Part B Surcharge | Part D Surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $0.00 |
| $109,001 to $137,000 | $218,001 to $274,000 | $81.20 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $202.90 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $324.60 | $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $446.30 | $83.30 |
| $500,000 or more | $750,000 or more | $487.00 | $91.00 |
To easily determine your exact penalty and estimate your monthly healthcare costs, use our Medicare Part B Premium Calculator.
How to Appeal an IRMAA Surcharge (Form SSA-44)
Because IRMAA relies on a 2-year lookback, your 2024 income may not accurately reflect your current financial situation in 2026. If you believe the IRMAA determination is incorrect or your income has drastically decreased, you have the right to appeal the surcharge with the Social Security Administration.
To request a reduction in your premium, you must file Form SSA-44 to prove that you experienced a qualifying "Life-Changing Event" that resulted in a significant reduction to your MAGI. The SSA recognizes the following eight life-changing events for an IRMAA appeal:
- Work stoppage: Such as full retirement or getting laid off.
- Work reduction: Such as switching from full-time to part-time employment.
- Death of a spouse: Which reduces your household income.
- Marriage: Which alters your filing status and combined income thresholds.
- Divorce or annulment: Which separates your income from your former spouse.
- Loss of income-producing property: Due to a natural disaster, arson, fraud, or theft (not a voluntary sale).
- Loss of pension income: Due to scheduled cessation, termination, or reorganization.
- Employer settlement payment: Receiving a settlement because of an employer's bankruptcy or reorganization.
If your appeal is approved, the SSA can update your records using a more recent tax year's income to determine your premium, potentially reducing or eliminating your IRMAA surcharge entirely.
This guide is for informational purposes. Read our full Disclaimer.