IRMAA – What It Is and What to Do About It

IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added to your Medicare Part B premium, and to your drug coverage, when your income is above a certain level.

It is not a penalty, and it doesn't mean you did anything wrong. It is simply how Medicare prices Parts B and D for higher earners. Roughly 8% of people on Medicare pay it.

How Medicare decides if you owe it

Social Security looks at your tax return from two years earlier. Specifically, your modified adjusted gross income (MAGI): your adjusted gross income plus any tax-exempt interest.

• 2026 premiums are based on your 2024 tax return.
• 2027 premiums will be based on your 2025 tax return.

Social Security sends a letter if you owe IRMAA. The amount is usually taken out of your Social Security check along with your Part B premium.

2026 IRMAA charts

Here are the 2026 charts showing the income levels and related IRMAA amounts. They're based on your 2024 tax return, and they're per person: if you're married and both on Medicare, you each pay.

Tap a chart to open it full size. The Part D amount is added on top of your drug plan's own premium. Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles fact sheet.

Four things people miss

• It's a cliff, not a slope. One dollar over a bracket line puts you in the full higher bracket for the whole year.
• It's per person. A married couple both on Medicare pays IRMAA twice.
• Medicare Advantage doesn't avoid it. You still pay Part B IRMAA, and the Part D add-on applies to the drug coverage inside your Advantage plan.
• Your Medigap premium doesn't change. Medicare Supplement prices are not based on income. IRMAA only touches Parts B and D.

What to do about it

1. Your income dropped? Ask Social Security to use a newer year

The two-year lookback is why IRMAA catches so many new retirees. Your 2024 income may have included a full salary you no longer earn. If a life-changing event lowered your income, you can ask Social Security to use a more recent year with form SSA-44.

Qualifying events:

• You stopped working or cut back your hours
• Marriage, divorce or annulment
• Death of a spouse
• Loss of income-producing property (for example, a disaster or theft)
• Loss or reduction of pension income
• An employer settlement payment

You file the SSA-44 with Social Security, along with proof of the event and your income (for example, a letter from your former employer and your estimate for the current year). If they approve it, your IRMAA is lowered or removed.

2. The tax information is wrong? Request a new decision

If you filed an amended return, or the income Social Security used is simply incorrect, contact Social Security and ask for a new initial determination using the corrected information.

3. Plan ahead before big income years

Roth conversions, selling a home or investments, and large IRA withdrawals can all push you into a higher bracket two years later. Your tax professional or financial advisor can help you time these. We're not CPAs, so please run the numbers with them.