Medicare IRMAA in 2026: Surcharges, Income Limits, and How to Appeal
Originally posted May 2023 / updated September 2026
Planning for Medicare is an important part of retirement planning, but the cost of Medicare is not the same for everyone.
Higher-income Medicare beneficiaries may pay an additional surcharge on their Medicare Part B and Part D premiums. This surcharge is called the Income-Related Monthly Adjustment Amount, or IRMAA.
IRMAA often catches retirees by surprise because Medicare generally looks back two years when determining the surcharge. That means your 2026 Medicare premiums are generally based on income reported on your 2024 federal tax return.
The good news: in some situations, particularly after retirement or another major life change, you may be able to ask Social Security to recalculate your Medicare premiums using more current income information.
What Is Medicare IRMAA?
IRMAA is an additional amount added to Medicare Part B and Part D premiums when your income exceeds certain thresholds.
For 2026, the standard Medicare Part B premium is $202.90 per month. Beneficiaries subject to IRMAA pay that standard premium plus an additional monthly amount. Part D works a little differently: you pay your regular prescription drug plan premium plus a separate IRMAA surcharge.
Social Security determines IRMAA using your modified adjusted gross income, or MAGI. For Medicare purposes, that generally means your adjusted gross income plus tax-exempt interest.
2026 Medicare IRMAA Brackets
For 2026, IRMAA begins when 2024 MAGI exceeds $109,000 for an individual filer or $218,000 for a married couple filing jointly.
| 2024 MAGI | Married Filing Jointly | 2026 Part B Premium | 2026 Part D IRMAA* |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | $14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | $37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | $60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | $83.30 |
| $500,000+ | $750,000+ | $689.90 | $91.00 |
*The Part D IRMAA amount is added to your regular Part D plan premium.
One of the frustrating features of IRMAA is that these are cliff thresholds. If your income crosses into the next bracket, even by a relatively small amount, the higher surcharge generally applies for the year. For a married couple where both spouses are on Medicare, crossing a threshold can therefore mean a noticeable increase in household Medicare costs.
Why Medicare Uses Income From Two Years Ago
Medicare generally relies on the most recent federal tax return information available from the IRS. For example: 2026 Medicare premiums are generally based on your 2024 tax return. That system works reasonably well while income is stable. But it can create a mismatch when someone retires.
Imagine that you earned a full salary in 2024, retired in 2025, and entered 2026 with substantially lower income. Medicare may initially calculate your 2026 premiums using your higher 2024 income, even though that income no longer reflects your current financial situation. That is where an IRMAA reconsideration may become valuable.
Can You Appeal Medicare IRMAA After Retirement?
Often, yes. If your household income has gone down because of a qualifying life-changing event (like retirement), Social Security allows you to request a new IRMAA determination.
Social Security recognizes the following qualifying events:
- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage
- Reduction in work
- Certain losses of income-producing property
- Certain losses or reductions of employer pension income
- Certain employer settlement payments related to bankruptcy or reorganization
For many of our clients, retirement or a significant reduction in work is the reason an IRMAA reconsideration comes into play.
An Example: Retiring After a High-Income Year
A married couple had MAGI of $300,000 in 2024 while both spouses were working. Based on the 2026 IRMAA brackets, each Medicare-enrolled spouse could initially be assessed a Part B premium of $405.80 per month, plus a Part D surcharge of $37.50 per month.
If one spouse retired in 2025 and the couple expects their 2026 income to be only $180,000, that’s cause to ask Medicare for a redetermination. Because a work stoppage is a qualifying life-changing event, they may be able to ask Social Security to use their more recent, lower income rather than the older 2024 income used initially. Social Security specifically allows beneficiaries to request this type of new determination when a life-changing event materially reduces MAGI. That can translate into meaningful savings.
How to Request a Lower IRMAA
The form commonly used is Form SSA-44, Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event. You may complete the form online, mail or fax it to Social Security, or contact Social Security to request assistance.
You will generally need to provide:
- Evidence of the qualifying life-changing event, such as retirement or reduced work; and
- Information supporting your more recent or expected MAGI.
Social Security may use a more recent tax return if one is available. If you have not yet filed a return reflecting your lower income, Social Security can in some circumstances work from an estimate of your expected MAGI, subject to its documentation requirements.
What If Social Security Used Incorrect Tax Information?
A life-changing event is not the only reason Medicare’s income determination may need to be corrected.
You may also be able to request a new determination if:
- You filed an amended tax return;
- The IRS information Social Security received was incorrect;
- Social Security used tax information from three years earlier because newer information was unavailable; or
- Certain filing-status circumstances changed.
These situations are handled somewhat differently from a life-changing-event request. Social Security directs people with an amended tax return to contact the agency about lowering IRMAA rather than simply treating the matter as an SSA-44 life-changing-event claim.
A Common Misunderstanding: Not Every Drop in Income Qualifies
This is an important distinction. Your income being lower this year does not automatically mean Social Security will recalculate IRMAA. There generally needs to be a qualifying event or another recognized reason for Social Security to use different tax information.
For example, simply spending down an inherited IRA and therefore having fewer taxable IRA distributions in a later year is not, by itself, one of the qualifying life-changing events listed on Form SSA-44. Likewise, voluntarily selling an income-producing asset does not generally qualify as a “loss of income-producing property.” Social Security specifies that this category generally involves a loss outside your control, such as certain disaster, theft, fraud, or similar circumstances.
That makes it important to understand why income changed, not just that it changed.
Do You Have to Request an IRMAA Adjustment More Than Once?
Potentially. Because Medicare uses a rolling two-year lookback, a retirement can affect more than one premium year. For example, if you retire during 2026, your 2026 and 2027 Medicare premiums could still reflect earlier working years. Depending on the timing of retirement and the tax returns Social Security has available, you may need to provide updated information again for a later year. Eventually, the normal two-year lookback catches up and your Medicare premium calculation reflects your post-retirement income.
Why IRMAA Matters in Retirement Tax Planning
The bigger lesson is that Medicare premiums are part of tax planning.
Income decisions that may affect MAGI include:
- Roth conversions
- Realizing capital gains
- IRA and retirement-plan distributions
- Required minimum distributions
- Interest and dividend income
- Tax-exempt municipal bond interest
That does not necessarily mean you should avoid an otherwise sensible tax or investment decision simply to stay under an IRMAA threshold. Sometimes paying an additional Medicare surcharge for a year is entirely reasonable if it accompanies a Roth conversion, portfolio change, or other strategy that provides a larger long-term benefit.
The important part is knowing the consequence before making the decision.
Medicare Planning Is About More Than the Premium
Medicare can intersect with retirement income, taxes, investment decisions, Social Security, and the timing of retirement itself.
If you are approaching Medicare age (or already enrolled) it can be helpful to look at those decisions together rather than treating Medicare as a standalone enrollment decision. For more background, see our guide to Medicare: Understanding Coverage Options and Costs.
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