Medicare Part B Premium & IRMAA Brackets 2026

Reviewed against CMS 2026 data · Last reviewed: June 2026

The standard 2026 Medicare Part B premium is $202.90 a month — but higher earners pay more through IRMAA (the Income-Related Monthly Adjustment Amount). IRMAA is based on the income you reported two years earlier, so your 2024 tax return sets your 2026 premium. This guide lays out the full 2026 IRMAA brackets for Part B and Part D, explains how the surcharge is triggered, and shows how to appeal it after a life-changing event.

What is IRMAA?

Most people pay the standard Part B premium, but Medicare charges higher-income beneficiaries an extra amount called IRMAA. It applies to both Part B and Part D, and it’s recalculated every year using your modified adjusted gross income (MAGI) from the tax return two years prior. For 2026, that’s your 2024 return. MAGI is your adjusted gross income plus any tax-exempt interest.

2026 Part B premium & IRMAA brackets

Married filing separately uses a separate two-step schedule: at or below $109,000 you pay the standard premium; above roughly $394,000 you pay the top amount, with a middle tier in between. Confirm your exact figure at Medicare.gov.

Don’t forget Part D IRMAA

If your income crosses the same thresholds, you also pay a Part D IRMAA surcharge on top of your drug plan’s premium. Unlike Part B, the Part D surcharge is added to whatever your private plan charges, and it rises through the same income tiers. If you have Medicare Advantage with drug coverage, the Part D IRMAA still applies.

How IRMAA is billed

If you receive Social Security, both the standard premium and any IRMAA are deducted from your monthly benefit. If you’re not yet collecting Social Security, Medicare bills you directly. The Part D surcharge is usually billed separately from your plan premium, even though the plan sets the base rate.

The two-year lookback (and why it surprises people)

Because IRMAA uses income from two years earlier, a one-time income spike — selling a home, a large Roth conversion, capital gains, or a year of high wages before retiring — can trigger a surcharge two years later, even if your current income is much lower. Planning the timing of big income events is the main way to manage IRMAA.

A quick IRMAA example

Suppose a married couple had 2024 MAGI of $280,000. In 2026 they fall in the third bracket, so each spouse pays $405.80 a month for Part B instead of $202.90 — about $2,400 more per person for the year, plus a Part D surcharge. Had their income been just under $274,000, they would have stayed in the second bracket. That is why a few thousand dollars of MAGI can matter so much near a threshold.

Who actually pays IRMAA?

Only a minority of beneficiaries pay IRMAA — the large majority fall under the first threshold and pay the standard $202.90. But the share grows over time because the brackets are not fully indexed to wage growth, and because retirees with sizable IRA or brokerage withdrawals can drift into the surcharge tiers. If you are anywhere near a bracket, it is worth checking your projected MAGI each autumn before year-end planning closes.

How to appeal IRMAA: Form SSA-44

If a life-changing event reduced your income — retirement, the death of a spouse, divorce, or loss of a pension or income-producing property — you can ask SSA to use your current income instead of the two-year-old figure. File Form SSA-44 with documentation. You can also appeal if the IRS data SSA used was wrong or out of date (for example, an amended return).

Common mistakes to avoid

• Ignoring the two-year lookback when planning a big income year.
• Crossing a bracket by a few dollars and paying a full tier more.
• Not filing SSA-44 after retirement drops your income.
• Forgetting Part D IRMAA — it’s a separate surcharge.

Related resources

• Medicare & Social Security: the Part B deduction — how the premium comes out of your check.
• Social Security in 2026: the complete guide
• Taxes on Social Security benefits 2026 — MAGI matters here too.
• Average & maximum benefit 2026

Frequently asked questions

What is the standard Medicare Part B premium for 2026?
$202.90 a month. You pay this standard amount if your 2024 modified adjusted gross income was $109,000 or less (single) or $218,000 or less (married filing jointly).

What are the 2026 IRMAA brackets?
Above the standard thresholds, Part B premiums rise in tiers: $284.10, $405.80, $527.50, $649.20, and $689.90 a month, based on 2024 MAGI for individuals and couples.

What income is IRMAA based on?
Your modified adjusted gross income (AGI plus tax-exempt interest) from two years earlier. For 2026 premiums, Medicare uses your 2024 tax return.

What is the highest Medicare Part B premium in 2026?
$689.90 a month, paid by individuals with 2024 MAGI of $500,000 or more (or couples at $750,000 or more).

Does IRMAA apply to Part D too?
Yes. High earners pay a Part D IRMAA surcharge added to their drug plan premium, rising through the same income tiers as Part B.

How do I appeal or reduce IRMAA?
If a life-changing event such as retirement, divorce, or a spouse’s death lowered your income, file Form SSA-44 so SSA uses your current income instead of the two-year-old figure.

Is IRMAA a one-time charge?
No. It’s a monthly surcharge for the whole year, and it’s recalculated annually from your most recent two-year-prior tax return, so it can change each year.

The Guru Gazette is an independent publisher and is not affiliated with Medicare, CMS, or the SSA. This is general information, not financial, tax, or insurance advice — confirm current brackets and your situation at Medicare.gov and SSA.gov. Last reviewed: June 2026.

Sources

• CMS — 2026 Medicare Parts A & B Premiums and Deductibles: https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
• Medicare.gov — Part B costs & IRMAA: https://www.medicare.gov/basics/costs/medicare-costs
• SSA — Medicare Premiums: Rules for Higher-Income Beneficiaries: https://www.ssa.gov/benefits/medicare/medicare-premiums.html
• SSA — Form SSA-44 (Life-Changing Event): https://www.ssa.gov/forms/ssa-44.pdf
• Medicare.gov — Part D costs: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage

People Also Ask

Which tax year determines my 2026 IRMAA?

Your 2026 IRMAA is based on the modified adjusted gross income reported on your 2024 federal tax return, because Medicare uses income from two years earlier. This two-year lookback means a recent change in income may not be reflected yet. If your income has since dropped due to a qualifying event, you may be able to ask SSA to use newer figures.

Can a one-time income spike trigger IRMAA?

Yes. Because IRMAA uses income from two years earlier, a single large event such as selling a home, a Roth conversion, capital gains, or a final year of high wages can push you into a surcharge tier two years later, even if your current income is much lower. Timing big income events carefully can help avoid this surprise.

Is IRMAA charged per person or per couple?

IRMAA is charged per person. Each enrolled spouse pays their own Part B premium and any surcharge based on the couple’s combined income. In the article’s example, a married couple over a threshold each paid the higher premium individually rather than one combined charge. The income limits, however, are measured against the couple’s joint income.

How is IRMAA paid?

If you receive Social Security, both the standard Part B premium and any IRMAA are deducted from your monthly benefit. If you are not yet collecting Social Security, Medicare bills you directly. Any Part D IRMAA is usually billed separately from your drug plan premium, even though the plan sets its own base premium.

What is Form SSA-44?

Form SSA-44 is the Medicare form you file with the Social Security Administration to request an IRMAA reduction after a life-changing event such as retirement, the death of a spouse, divorce, or loss of pension income. You submit it with supporting documentation so SSA can use your current income instead of the figure from two years earlier.

Related guides

• Medicare 2026 Guide
• Medicare vs Medicaid: What’s the Difference? (2026)
• Medicare Parts A, B, C & D Explained (2026)
• Medicare Enrollment 2026: IEP, GEP, SEP & How to Sign Up
• Medicaid 2026 Guide
• Social Security 2026 Guide

Reviewed by the Guru Gazette Editorial Review Team · Last reviewed June 2026. Figures are verified against official government sources; see our Fact-Checking Policy.