Medicare IRMAA

Understanding Medicare IRMAA: Income Brackets, Costs, and How to Appeal

One of the biggest surprises for some people when they become eligible for Medicare is learning that not everyone pays the same amount for Medicare Part B and Part D.

People with higher incomes may be required to pay an additional amount called IRMAA.

IRMAA stands for Income-Related Monthly Adjustment Amount.

In simple terms:

IRMAA is an extra Medicare premium charged to people whose income is above certain levels.

It can increase what you pay for both:

• Medicare Part B — your medical insurance
• Medicare Part D — your prescription drug coverage

The important thing to understand is that IRMAA is not a separate insurance plan and doesn’t give you additional benefits. It’s simply an additional amount you’re required to pay because of your income.

How Does Medicare Determine Your Income?

Here’s where IRMAA can become confusing.

Social Security generally determines your IRMAA using tax information from two years earlier.

For your 2026 Medicare premiums, Social Security generally looks at the Modified Adjusted Gross Income, or MAGI, reported on your 2024 federal tax return. (Social Security Administration)

In simple terms, MAGI for IRMAA purposes is generally your:

Adjusted Gross Income + tax-exempt interest

This creates an important situation for people who are retiring.

Imagine that in 2024 you were still working and earning a large salary.

Then you retire in 2026.

Your income may have dropped dramatically, but Medicare is initially looking at what you earned while you were still working.

That’s why understanding the IRMAA appeal process is so important.

2026 Medicare IRMAA Income & Premium Chart

The standard Medicare Part B premium for 2026 is $202.90 per month. The following chart shows how IRMAA increases that amount based on 2024 income. (Centers for Medicare & Medicaid Services)

2024 MAGI — Individual	2024 MAGI — Married Filing Jointly	Standard Part B	Additional Part B IRMAA	Total Part B Premium	Additional Part D IRMAA	Part B + Both IRMAAs
$109,000 or less	$218,000 or less	$202.90	$0	$202.90	$0	$202.90 + Part D plan premium
$109,001–$137,000	$218,001–$274,000	$202.90	$81.20	$284.10	$14.50	$298.60 + Part D plan premium
$137,001–$171,000	$274,001–$342,000	$202.90	$202.90	$405.80	$37.50	$443.30 + Part D plan premium
$171,001–$205,000	$342,001–$410,000	$202.90	$324.60	$527.50	$60.40	$587.90 + Part D plan premium
$205,001–$499,999	$410,001–$749,999	$202.90	$446.30	$649.20	$83.30	$732.50 + Part D plan premium
$500,000 or more	$750,000 or more	$202.90	$487.00	$689.90	$91.00	$780.90 + Part D plan premium

Amounts are monthly and are based on the official 2026 Medicare IRMAA brackets. The table above covers individual and married-filing-jointly tax statuses; special rules apply to married people who file separately. The Part D IRMAA is added to whatever premium the person’s actual Part D drug plan charges, so there isn’t one universal “total Medicare premium” that applies to everyone. (Centers for Medicare & Medicaid Services)

Let’s Put That Chart Into Plain English

Suppose you’re single and your 2024 MAGI was $150,000.

That puts you in the third income bracket.

Instead of paying the standard:

$202.90 Part B premium

you would pay:

$405.80 per month for Part B.

If you also have Part D, another:

$37.50 per month

would be added as your Part D IRMAA.

So before we even include the premium charged by your actual prescription drug plan, you’re looking at:

$405.80 + $37.50 = $443.30 per month

Then you would add whatever premium your particular Part D plan charges.

That’s an important distinction:

Part D IRMAA does not replace your drug plan premium. It’s added to it. (Social Security Administration)

IRMAA Can Become Expensive Quickly

Look at someone in the highest bracket.

Their Part B premium isn’t $202.90.

It’s:

$689.90 per month.

Then there’s another:

$91.00 per month for Part D IRMAA.

That’s:

$780.90 per month before adding the actual Part D plan premium. (Social Security Administration)

And remember, paying IRMAA doesn’t buy that person better Medicare coverage.

They’re paying more for the same Medicare Part B benefits because their income falls into a higher bracket.

What If I’m Retiring and Don’t Make That Much Money Anymore?

This is where IRMAA becomes especially important for someone transitioning into Medicare.

Imagine this situation:

2024: You’re working full-time and have a high income.

2026: You retire, enroll in Medicare, and your income drops substantially.

Social Security looks at your 2024 tax return and determines that you owe IRMAA.

Your reaction might understandably be:

“But I don’t make that kind of money anymore!”

Social Security recognizes that this happens.

If your income has decreased because of certain life-changing events, you may be able to ask Social Security to reconsider your IRMAA based on your newer, lower income. (Social Security Administration)

What Counts as a Life-Changing Event?

Social Security recognizes several events that may allow someone to request a lower IRMAA, including:

• Marriage
• Divorce or annulment
• Death of a spouse
• Stopping work
• Reducing your work
• Loss of income-producing property
• Loss of certain pension income
• Certain employer settlement payments

For someone entering Medicare, retirement or substantially reducing work is one of the most common situations. (Social Security Administration)

How Do You Ask Social Security to Lower Your IRMAA?

The form you’ll commonly use is:

Form SSA-44

Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event

The SSA-44 essentially allows you to tell Social Security:

“The income you’re looking at no longer represents my current financial situation because something significant has changed.”

You’ll identify the life-changing event, when it occurred, and your newer or expected income.

Social Security says the request can be submitted online in qualifying circumstances, or the completed SSA-44 and supporting evidence can be faxed or mailed to a Social Security office. (Social Security Administration)

You Don’t Necessarily Have to Wait for Another Tax Return

This is particularly helpful for someone who has just retired.

Social Security’s current SSA-44 allows you to report an income reduction that has already occurred or that you anticipate occurring during the current or following year. (Social Security Administration)

So imagine:

2024 MAGI: $175,000

You retire during 2026 and reasonably expect your new MAGI to be:

$80,000

You don’t necessarily have to accept the higher IRMAA simply because Social Security initially sees that $175,000 figure.

You can ask Social Security to consider your newer income because your work stoppage caused your income to decrease.

You’ll need appropriate evidence supporting both the life-changing event and the more recent income information or estimate. (Social Security Administration)

A Simple Example

Let’s say John is single.

John worked throughout 2024 and had MAGI of:

$180,000

John retires in 2026.

Because Medicare generally looks back two years, Social Security initially sees that $180,000 income.

Based on the 2026 table, John’s Part B premium could therefore be:

$527.50 per month

and his Part D IRMAA could be another:

$60.40 per month.

That’s $587.90 per month before his actual Part D plan premium. (Social Security Administration)

But John is now retired.

Suppose he reasonably expects his 2026 MAGI to be only:

$85,000

That’s below the 2026 IRMAA threshold for an individual.

John can submit an SSA-44 explaining that he stopped working and his income has decreased.

If Social Security accepts his request and determines that his newer income should be used, his IRMAA could potentially be reduced all the way to $0.

Instead of paying:

$527.50 for Part B + $60.40 Part D IRMAA

he could potentially return to:

$202.90 for Part B + $0 Part D IRMAA

plus whatever premium his actual Part D plan charges.

That’s a difference of:

$385 per month

or:

$4,620 over 12 months.

The Most Important Thing to Remember

IRMAA is essentially a higher-income surcharge on Medicare Part B and Part D.

Medicare normally looks at income from two years earlier.

That’s usually fine when your income hasn’t changed much.

But retirement creates a unique problem:

Medicare may be looking at your working income when you’re now living on retirement income.

If you’ve retired, reduced your work, or experienced another qualifying life-changing event and your income has dropped, don’t automatically assume the higher premium is permanent.

Look at your IRMAA notice, determine why Social Security assessed the additional premium, and see whether your situation qualifies for reconsideration.

For many new retirees, the conversation with Social Security is essentially:

“The tax return you’re looking at reflects what I made while I was working. I have now retired, my income has substantially decreased, and I’d like you to reconsider my IRMAA using my newer income.”

The form designed for that situation is the SSA-44.

And that can potentially mean the difference between paying hundreds of dollars in additional Medicare premiums each month and paying the standard Medicare premium instead.

On the other end of the income scale, people with limited income may qualify for help paying for Medicare in Alabama. You can also see how the parts fit together in our Traditional Medicare overview.