What IRMAA means for Medicare
IRMAA stands for income-related monthly adjustment amount. It is not a separate Medicare plan. It is an additional amount paid by certain higher-income beneficiaries for Medicare Part B and, when applicable, Part D prescription coverage.
Why the two-year lookback matters
Social Security generally uses modified adjusted gross income from the federal tax return filed two years earlier. For 2026, that usually means 2024 income. A recent retirement, business or property sale, large capital gain, Roth conversion, required minimum distribution, or other one-time income event can make that older return look very different from your income today.
2026 IRMAA brackets at a glance
The table below shows the 2026 amounts for individual and married filing-jointly returns. The Part D amount is added to your plan premium. A separate table below shows the brackets for married people who filed separately and lived with their spouse during the relevant tax year.
| 2024 income — individual | 2024 income — joint | 2026 Part B monthly premium | 2026 Part D monthly adjustment |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $60.40 |
| Above $205,000 and below $500,000 | Above $410,000 and below $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Amounts are based on official 2026 Medicare figures. Review your Social Security notice and the current official tables for the determination that applies to you.
Married filing separately: 2026 IRMAA brackets
This table applies if you filed a separate tax return and lived with your spouse at any time during 2024, the tax year generally used for 2026 IRMAA. The Part B amount is the total monthly premium; the Part D adjustment is added to your plan premium.
| 2024 modified adjusted gross income | 2026 Part B monthly premium | 2026 Part D monthly adjustment |
|---|---|---|
| $109,000 or less | $202.90 | $0 |
| Above $109,000 and below $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91.00 |
The lived-with-your-spouse condition matters. If you lived apart for the entire tax year, do not assume this special table applies. Review your Social Security determination or contact Social Security to confirm the brackets used for your situation.
When reconsideration may be possible
If your income has gone down because of a qualifying life-changing event, Social Security may reconsider the income information used for IRMAA. Examples can include marriage, divorce or annulment, death of a spouse, work stoppage or reduction, loss of income-producing property, loss of certain pension income, or an employer settlement payment.
Social Security makes the determination. Its official guidance explains the process and when to submit Form SSA-44.
How Swift Retirement can help
Evan Howard can explain how Part B and Part D costs interact with the Medicare coverage you are considering, help you prepare the right questions for Social Security, and coordinate the Medicare conversation with your tax or financial professional when appropriate. Choosing a Medicare Advantage, Supplement, or Part D plan does not by itself remove an IRMAA obligation.
For a broader coverage review, visit our Bloomington Medicare help page or request an appointment below.
Frequently asked IRMAA questions
What is IRMAA?
IRMAA is an income-related adjustment added to Medicare Part B and, when applicable, Part D costs for beneficiaries whose modified adjusted gross income is above annual thresholds.
Which tax year is used for 2026 IRMAA?
Social Security generally uses your 2024 federal tax return to determine a 2026 IRMAA amount. If that information is unavailable, it may use other available tax data.
Does choosing Medicare Advantage avoid IRMAA?
No. A person enrolled in Medicare Advantage can still owe the Part B premium and may owe a Part D income-related adjustment when prescription coverage is included.
Can IRMAA be reconsidered after retirement?
Possibly. Retirement or another qualifying life-changing event that reduces household income may support a request for reconsideration. Social Security makes the decision and may require Form SSA-44 and supporting documents.
Important information
This page is for general educational purposes and was reviewed in October 2026. It is not tax, legal, accounting, or investment advice. Swift Retirement does not determine, reduce, or appeal IRMAA; the Social Security Administration makes those decisions. Medicare amounts and thresholds can change each year.