Medicare is not priced the same for everyone. If your income from two years ago was above a set level, you pay an income-related monthly adjustment amount (IRMAA) on top of the standard Part B premium, and on top of your Part D drug plan's premium. The surcharge is a cliff: one dollar of income over a threshold moves you into the next tier.
This guide gives the 2026 brackets for every filing status, explains which year's income counts, works through a real example, and lists the only events that let you ask SSA to use a different year. The standard premium and deductible are in our Medicare Part B premium guide.
These are the 2026 income-related monthly adjustment amounts (IRMAA). The income that counts is your modified adjusted gross income (MAGI) from 2024, or from 2023 if 2024 is not available. Part B totals are the full monthly Part B premium you pay; the Part D column is the extra amount you pay on top of your drug plan's own premium.
| MAGI, single filers | MAGI, joint filers | Monthly IRMAA, Part B | Total monthly Part B premium | Monthly IRMAA, Part D |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $202.90 | $0.00 |
| $109,000 to $137,000 | $218,000 to $274,000 | $81.20 | $284.10 | $14.50 |
| $137,000 to $171,000 | $274,000 to $342,000 | $202.90 | $405.80 | $37.50 |
| $171,000 to $205,000 | $342,000 to $410,000 | $324.60 | $527.50 | $60.40 |
| $205,000 to under $500,000 | $410,000 to under $750,000 | $446.30 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $487.00 | $689.90 | $91.00 |
The thresholds are cliffs, not gradual: the table reads "greater than" the lower figure, so a MAGI of exactly $109,000 (single) pays the standard premium, and $109,001 pays $81.20 more a month. Sources: the CMS 2026 premiums fact sheet and SSA's Program Operations Manual System (POMS) HI 01101.020.
People who are married, lived with their spouse at any time during the tax year and file separately face much lower thresholds. For 2026, a MAGI above $109,000 but under $391,000 means a total Part B premium of $649.20 (and a $83.30 Part D adjustment); a MAGI of $391,000 or more means $689.90 (and $91.00 for Part D), according to SSA's POMS.
| MAGI, married filing separately (lived together) | Total monthly Part B premium | Monthly IRMAA, Part D |
|---|---|---|
| $109,000 or less | $202.90 | $0.00 |
| More than $109,000, under $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91.00 |
IRMAA is based on a tax return from two years before the premium year (three years back if the more recent return is not available). For 2026 premiums that means your 2024 income. The same rule means 2027 premiums will use your 2025 income, so a high-income year in 2025, such as a large capital gain or a Roth conversion, can raise your 2027 Medicare premium even if your income drops in 2026. See our Roth conversion ladder guide for how conversions raise MAGI.
A single retiree had a 2024 MAGI of $120,000. That is above $109,000 but not above $137,000, so for 2026 their total Part B premium is $284.10 instead of $202.90 (CMS).
| Item | Per month | Per year |
|---|---|---|
| Part B IRMAA ($284.10 - $202.90) | $81.20 | $974.40 |
| Part D IRMAA | $14.50 | $174.00 |
| Extra cost of crossing the first threshold | $95.70 | $1,148.40 |
The Part D amount is paid on top of the plan's own premium. If the same retiree's MAGI had been $109,000 or less, none of this would apply.
The Part B premium has been based on income since 2007, and CMS says the income-related adjustments affect roughly 8% of people with Part B.
The first threshold rose from MAGI above $106,000 in 2025 (total Part B premium $259.00 in the first tier) to above $109,000 in 2026 (total $284.10). The standard premium itself rose from $185.00 to $202.90. For the full 2026 premium, deductible and Part A figures, see our Medicare Part B premium guide.
SSA can use a more recent tax year if a life-changing event significantly reduced your income. The list is exclusive: death of a spouse, marriage, divorce or annulment, work reduction, work stoppage, loss of income-producing property, loss of an employer pension, or receipt of a settlement payment from a current or former employer. You request a new determination and attest under penalty of perjury; the optional form is SSA-44.
Events that do not count include an ordinary loss of dividend income, higher medical expenses, higher living expenses, loss of child support or alimony, and a voluntary sale of income-producing property. A one-time income spike, such as a capital gain, is treated as a non-qualifying event, which means it does not by itself let you use a different year.
The 2027 IRMAA thresholds and premiums have not been announced. CMS released the 2026 figures on November 14, 2025, so the 2027 numbers are expected in the autumn; this page will be updated when they are published. Until then, use the 2026 table above only for 2026. For the Social Security side of 2027, see our 2027 COLA guide.
Check the primary documents: CMS 2026 Medicare Parts A and B premiums and deductibles, SSA POMS HI 01101.020 (IRMAA tables) and SSA POMS HI 01120.005 (life-changing events).