Complete guide
Reviewed July 2026IRMAA — the Income-Related Monthly Adjustment Amount — is the extra premium higher-income Medicare beneficiaries pay for Part B and Part D. What makes IRMAA uniquely painful is the cliff structure: crossing a bracket threshold by a single dollar triggers the full surcharge for that tier, for both spouses, for an entire year.
This calculator tells you instantly which of the six 2026 IRMAA tiers you fall into based on your modified adjusted gross income (MAGI) — from your 2024 tax return, because Medicare uses a two-year lookback — and what it costs per month and per year.
The 2026 standard Part B premium is $202.90 per month. IRMAA can push that to $689.90, plus up to $91.00 on top of your Part D plan premium. For a married couple in the top tier, IRMAA alone exceeds $13,800 per year.
2026 IRMAA brackets and premiums
The 2026 tiers below are set by CMS from your 2024 MAGI (the income on the federal return you filed in 2025). The same income brackets apply to both Part B and Part D; only the dollar surcharges differ.
| Single filer MAGI | Married filing jointly | Part B premium | Part D add-on | Extra vs standard (mo.) |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 | $0 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | $14.50 | $95.70 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | $37.50 | $240.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | $60.40 | $385.00 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.30 | $83.30 | $529.70 |
| $500,000 and above | $750,000 and above | $689.90 | $91.00 | $578.00 |
Married filing separately
Married-filing-separately taxpayers who lived with their spouse face a harsher schedule: the standard premium applies only up to $109,000 MAGI, then income above that jumps straight to the two highest tiers (the top tier starting at just $391,000). MFS is rarely advantageous for Medicare households.
How IRMAA works
The two-year lookback
Social Security determines your 2026 IRMAA from the MAGI on your 2024 return — the most recent return the IRS had processed when 2026 premiums were set. This lag catches many new retirees: your first years of Medicare are priced off your final, often highest-earning, working years.
MAGI for IRMAA purposes
IRMAA MAGI = Adjusted Gross Income (AGI) + tax-exempt interest Includes: wages, RMDs, Roth conversions, capital gains, dividends, rental income, taxable Social Security, pension income Excludes: Roth withdrawals, HSA withdrawals, QCDs, life-insurance proceeds
Note what's inside: Roth conversions and realized capital gains count in full, which is how one-time events — selling a rental property, a large conversion, exercising options — push retirees into IRMAA territory two years later. Note also what's outside: qualified Roth IRA withdrawals and qualified charitable distributions (QCDs) never touch MAGI.
The cliff, quantified
A single filer with 2024 MAGI of $109,000 pays $202.90/month in 2026. At $109,001 — one dollar more — the premium becomes $284.10 plus $14.50 for Part D: $1,148 more per year, caused by $1 of income. No other federal tax feature has a steeper marginal rate. This is why year-end income planning around the thresholds matters so much.
Strategies to reduce or avoid IRMAA
- Plan Roth conversions in brackets: convert up to — never over — an IRMAA threshold, and remember the effect lands two years later.
- Use QCDs after age 70½: donating up to $108,000 (2025 limit, indexed) directly from an IRA satisfies RMDs without adding to MAGI.
- Harvest capital losses to offset gains in years you're near a threshold.
- Spread large asset sales across tax years, or use instalment sales.
- Consider timing of the first RMD (age 73): delaying to April 1 doubles the next year's income — usually a mistake for IRMAA.
- Fund early-retirement spending from Roth or taxable-basis withdrawals in the two years before Medicare enrollment.
Appealing IRMAA after a life change
If your income has dropped since the lookback year due to a life-changing event, file form SSA-44 to have IRMAA recalculated using your more recent income. Qualifying events include: work stoppage or reduction (retirement), marriage, divorce or annulment, death of a spouse, loss of income-producing property from a disaster, loss of pension income, and an employer settlement payout.
Retirement is by far the most common successful appeal — a new retiree whose $250,000 salary ended can have IRMAA based on their actual, lower retirement income instead. A one-time capital gain or Roth conversion is not an appealable event; those simply age out of the lookback after a year.
How to use this calculator
- Select your tax filing status (single/head of household, or married filing jointly).
- Enter your MAGI from two years before the premium year — for 2026 premiums, your 2024 AGI plus tax-exempt interest.
- Read your tier, total Part B premium, Part D surcharge, and the annual extra cost versus the standard premium.
- If you're doing year-end planning, test incomes just below and just above the nearest threshold to see exactly what crossing it costs.
Frequently asked questions
Glossary
- IRMAA
- Income-Related Monthly Adjustment Amount — the income-based surcharge on Medicare Part B and D premiums.
- MAGI
- For Medicare: adjusted gross income plus tax-exempt interest, from the return two years prior.
- Two-year lookback
- The rule that year-N premiums are based on year-(N−2) income.
- SSA-44
- The Social Security form used to request an IRMAA reduction after a qualifying life-changing event.
- QCD
- Qualified Charitable Distribution — an IRA-to-charity transfer (70½+) that satisfies RMDs without entering MAGI.
- RMD
- Required Minimum Distribution — mandatory annual withdrawals from pre-tax retirement accounts, currently from age 73.
- Roth conversion
- Moving pre-tax retirement money into a Roth account, paying tax now to eliminate future taxable income.
- Part B / Part D
- Medicare's outpatient/medical coverage (B) and prescription drug coverage (D), the two premiums IRMAA raises.
- Cliff threshold
- A limit where exceeding it by any amount triggers the entire surcharge, with no phase-in.
Key takeaways
IRMAA turns Medicare premiums into a six-tier system priced off your income from two years ago, with cliff thresholds at $109K/$137K/$171K/$205K/$500K (single, 2026). The defenses are timing and account type: convert to Roth in measured slices before 63, use QCDs for giving, harvest losses against gains, keep an eye on the thresholds every December — and file SSA-44 the year you retire.
Enter your filing status and 2024 MAGI above to see your exact 2026 tier — then test how a planned Roth conversion or asset sale would change it.