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2026 IRMAA brackets: Medicare premiums by income
By Secure Retirement PlannerUpdated
In 2026, Medicare Part B costs $202.90 a month unless your 2024 income was above $109,000 (single) or $218,000 (married filing jointly). Above those lines you pay an income-related surcharge called IRMAA, up to $689.90 a month for Part B plus up to $91.00 a month extra for Part D.
IRMAA uses your modified adjusted gross income (MAGI) from two years earlier. That's why a Roth conversion in 2026 can raise your Medicare premiums in 2028. Use the checker below, then see Roth conversions and IRMAA for how to plan around it.
Check your IRMAA tier
Your AGI plus tax-exempt interest. Use 2024 income for 2026 premiums, or your expected 2026 income to plan for 2028.
Your IRMAA tier
No surcharge
Part B $202.90 + Part D add-on $0.00 a month per person
Surcharge per year (both of you)
$0
Above the standard premium
Room before the next tier
$38,000
Going over adds about $2,297 a year
Uses official 2026 CMS amounts. Future years' thresholds adjust for inflation. Get a conversion plan sized to your IRMAA line.
What are the 2026 IRMAA brackets?
These are the official 2026 amounts from CMS. Premiums are per person, so a married couple both on Medicare pays twice the monthly amount.
| Single (2024 MAGI) | Married filing jointly (2024 MAGI) | Part B monthly premium | Part D add-on |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Over $109,000 up to $137,000 | Over $218,000 up to $274,000 | $284.10 | +$14.50 |
| Over $137,000 up to $171,000 | Over $274,000 up to $342,000 | $405.80 | +$37.50 |
| Over $171,000 up to $205,000 | Over $342,000 up to $410,000 | $527.50 | +$60.40 |
| Over $205,000 up to $500,000 | Over $410,000 up to $750,000 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$91.00 |
Why is IRMAA called a cliff?
Tax brackets only tax the dollars above a line at the higher rate. IRMAA doesn't work that way. Going $1 over a threshold puts you in the higher tier for the whole year.
For a married couple, crossing $218,000 by one dollar adds $81.20 a month each to Part B and $14.50 each to Part D. That's about $2,297 for the year from a single dollar of income.
Planning tip
When you size a Roth conversion, leave a cushion of a few thousand dollars below the IRMAA line. Interest, dividends and capital gains distributions can come in higher than you expect.
Which year's income sets my premium?
Social Security uses the tax return from two years before. Your 2026 premiums are based on 2024 income, and 2028 premiums will be based on 2026 income.
MAGI for IRMAA is your adjusted gross income plus tax-exempt interest. Roth conversions, RMDs, capital gains and the taxable part of Social Security all count. Qualified Roth withdrawals don't.
| Income earned in | Affects Medicare premiums in |
|---|---|
| 2024 | 2026 |
| 2025 | 2027 |
| 2026 | 2028 |
| 2027 | 2029 |
How do Roth conversions affect IRMAA?
A conversion adds to your MAGI for that year, so it can lift you into a higher IRMAA tier two years later. But over a lifetime, conversions can lower IRMAA, because qualified Roth withdrawals don't count as income and smaller RMDs keep later-year income down.
Many people time larger conversions for before age 63, since income at 63 sets premiums at 65. After that, they convert up to just under an IRMAA line each year. Our Roth conversion tax calculator flags when a conversion crosses a line.
Can I appeal IRMAA if my income dropped?
Yes, if your income fell because of a life-changing event. Social Security accepts form SSA-44 for events such as retirement or reduced work hours, marriage, divorce, death of a spouse, loss of income-producing property, or loss of a pension.
A Roth conversion or selling investments is not a life-changing event, so you can't appeal a surcharge caused by those.
What are the 2027 IRMAA brackets?
As of November 9, 2026, CMS had not yet published the official 2027 Part B premium and IRMAA amounts. They are usually announced in mid November. The thresholds are adjusted for inflation each year. We'll update this page when CMS publishes them.
Common questions
What is the IRMAA threshold for 2026?
IRMAA starts when 2024 MAGI was above $109,000 for single filers or above $218,000 for married couples filing jointly.
What is the 2026 Medicare Part B premium?
The standard 2026 Part B premium is $202.90 a month. With IRMAA it ranges from $284.10 to $689.90 a month per person.
Does a Roth conversion count toward IRMAA?
Yes. The converted amount is part of your MAGI for that year and affects your premiums two years later.
Do Roth IRA withdrawals count for IRMAA?
Qualified Roth IRA withdrawals don't count as income, so they don't raise IRMAA. That's one reason retirees convert before Medicare.
Is IRMAA per person or per couple?
Per person. Each spouse on Medicare pays the surcharge, but the tier is set by the couple's joint income if you file jointly.
How do I appeal an IRMAA surcharge?
File form SSA-44 with Social Security if a life-changing event, such as retiring or losing a spouse, lowered your income.
Sources
Facts on this page were last checked on November 9, 2026.
- CMS: 2026 Medicare Parts A & B premiums and deductibles · 2026 Part B premiums and Part D IRMAA amounts by income. Read Nov 9, 2026.
- SSA: Medicare premiums, rules for higher-income beneficiaries · Two-year lookback and life-changing events. Read Nov 9, 2026.
- SSA form SSA-44, Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event · Appeal reasons. Read Nov 9, 2026.
- Medicare.gov: Part B costs · Standard premium. Read Nov 9, 2026.