2026 IRMAA: Deep Dive into the Surcharges
The Income-Related Monthly Adjustment Amount (IRMAA) is essentially a "means-testing" mechanism for Medicare. If your income exceeds certain levels, you pay the standard premium plus an additional surcharge.
Medicare determines your 2026 status using your 2024 tax returns. Here is a detailed breakdown of the financial impacts.
Part B: Medical Insurance Premiums
The standard monthly premium for Medicare Part B is $202.90 in 2026. If you fall into an IRMAA bracket, your total monthly cost increases as follows:
Individual Income (2024) Joint Income (2024) Total Monthly Premium
$109,000 or less $218,000 or less $202.90 (Standard)
$109,001 – $137,000 $218,001 – $274,000 $284.10
$137,001 – $171,000 $274,001 – $342,000 $405.80
$171,001 – $205,000 $342,001 – $410,000 $527.50
$205,001 – $499,999 $410,001 – $749,999 $649.20
$500,000 or more $750,000 or more $689.90
Part D: Prescription Drug Premiums
Unlike Part B, Part D premiums vary by plan. However, the IRMAA surcharge is fixed based on your income and is added to whatever base premium your plan charges.
- Bracket 1: +$14.50 /month
- Bracket 2: +$37.50 /month
- Bracket 3: +$60.40 /month
- Bracket 4: +$83.30 /month
- Highest Bracket: +$91.00 /month
How to Appeal or Reduce Your IRMAA
If your income has dropped significantly since 2024, you don't necessarily have to pay these higher rates. The Social Security Administration (SSA) allows for appeals based on "Life-Changing Events" (LCE).
- Valid LCEs include: Retirement (work stoppage/reduction), divorce, death of a spouse, or loss of income-producing property.
- The Process: You must file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event).
- Amended Returns: If you filed an amended tax return for 2024 that lowers your MAGI below a threshold, you should notify the SSA immediately to have your premiums recalculated.
Important Note on MAGI
Your IRMAA is calculated using your Modified Adjusted Gross Income, which includes your adjusted gross income plus any tax-exempt interest income (like municipal bond interest). This is often where high-income earners are surprised by a bracket jump. Roth conversions will also increase your adjusted gross income.
Janney Montgomery Scott LLC, its affiliates, and its employees are not in the business of providing tax, regulatory, accounting, or legal advice. Any taxpayer should seek advice based on the taxpayer's particular circumstances from an independent tax advisor.
