What Is IRMAA? 2026 Medicare Income Surcharges

What Is IRMAA, and Why Do Some People Pay More for Medicare?

By Albert Ferrin, RSSA® | Senior Help And You, LLC | Reviewed July 2026

How Medicare Determines IRMAA

For 2026 premiums, Social Security generally uses income from your 2024 federal tax return. Medicare uses modified adjusted gross income, or MAGI. For IRMAA, MAGI is generally your adjusted gross income plus tax-exempt interest.

This two-year lookback is why someone who recently retired may receive an IRMAA notice based on income earned before retirement.

2026 Part B IRMAA Brackets

Different rules apply to certain married people who live with their spouse during the tax year and file separately.

Part D IRMAA

Higher-income beneficiaries may also pay an additional amount for Medicare drug coverage. In 2026, the Part D IRMAA surcharge ranges from $14.50 to $91.00 per month, depending on income.

You pay the Part D IRMAA to Medicare or Social Security, not to the drug plan. It is charged in addition to the plan’s regular premium.

Can You Ask Social Security to Lower IRMAA?

Possibly. Social Security may make a new decision if a recognized life-changing event reduces your household income.

Examples include:

·Marriage, divorce, annulment, or the death of a spouse.

·Stopping work or reducing work hours.

·Loss of income-producing property because of a disaster or another event beyond your control.

·Loss, termination, or reorganization of an employer pension plan.

·An employer settlement related to closure, bankruptcy, or reorganization.

You can use Form SSA-44 to request a new IRMAA determination after a qualifying life-changing event. Social Security may ask for proof of the event and evidence of your reduced income.

What If the Tax Information Is Wrong?

If Social Security used incorrect tax data, you may be able to request reconsideration. If your federal tax return itself is wrong, you may need to correct it with the IRS first.

Do not ignore an IRMAA notice. Review the tax year used, filing status, income amount, and appeal instructions.

Why Planning Matters

Large taxable events can affect Medicare premiums two years later. Examples may include a Roth conversion, a major capital gain, a large traditional IRA or 401(k) withdrawal, business income, or taxable investment income.

That does not mean you should avoid a financially sound decision solely because of IRMAA. It means the Medicare effect should be included in the tax and retirement analysis.

Frequently Asked Questions

Is IRMAA permanent?

Not necessarily. Social Security reviews income information for each year. Your surcharge may increase, decrease, or end as your income changes.

Does everyone pay IRMAA?

No. Most Medicare beneficiaries pay the standard premium. IRMAA applies only when income exceeds the applicable threshold.

Can an agent appeal IRMAA on my behalf?

An agent can help explain the notice, but Social Security decides IRMAA. Tax and legal questions should be reviewed with the appropriate professional.

Your Next Step

Need help understanding how these Medicare costs may apply to you? Call Senior Help And You, LLC at 520-252-5275 to schedule a personal Medicare review with Albert Ferrin, RSSA®.

Official Sources

·CMS: 2026 Medicare Parts A & B Premiums and Deductibles

·Social Security: Monthly Medicare Premiums for 2026

·Social Security: Request to Lower IRMAA

·Medicare.gov: Medicare & You 2026

Educational notice: This article provides general Medicare information and is not tax, legal, investment, or medical advice. Medicare costs and eligibility rules can change. Plan benefits, costs, networks, and availability vary by location. Senior Help And You, LLC is not connected with or endorsed by the U.S. government or the federal Medicare program.