What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added to your Medicare Part B and Part D premiums if your modified adjusted gross income (MAGI) exceeds certain thresholds.
The key thing to know: Social Security uses your income from 2 years ago (2024 tax return) to determine your 2026 premiums. This is called the "lookback" period.
2026 IRMAA Brackets (Source: CMS)
Standard Part B premium in 2026: $202.90/month. Lookback year: 2024 tax returns.
| 2024 MAGI — Individual | 2024 MAGI — Joint | Monthly Part B | Part D Add-On | Tier |
|---|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 | $0.00 | Standard |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | $14.50 | Tier 1 |
| $137,001–$164,000 | $274,001–$328,000 | $395.00 | $37.30 | Tier 2 |
| $164,001–$205,000 | $328,001–$410,000 | $506.00 | $60.10 | Tier 3 |
| $205,001–$500,000 | $410,001–$750,000 | $617.00 | $82.90 | Tier 4 |
| Above $500,000 | Above $750,000 | $689.90 | $91.00 | Tier 5 |
💡 Example: A married couple with $300,000 MAGI (joint) falls in Tier 2. Each spouse pays $395.00/month for Part B + $37.30 Part D add-on = $5,187.60 extra per year for the couple.
• IRMAA surcharges increased ~9% from 2025 to 2026 • Income thresholds increased ~3% (inflation adjustment) • The 5th bracket ($500K+/$750K+) is frozen until 2028 • Each spouse pays individually • Part D IRMAA is billed by Medicare, separate from your plan premium
What Counts — and Doesn't Count — Toward IRMAA
⚠️ Counts Toward MAGI (Increases IRMAA)
- Wages, salary, bonuses
- Traditional IRA / 401(k) distributions
- Roth conversions (counts in conversion year)
- Capital gains from investments
- Rental income
- Pension income
- Social Security benefits (taxable portion)
- Tax-exempt interest (municipal bonds)
✅ Does NOT Count (Safe from IRMAA)
- Qualified Roth IRA withdrawals
- HSA distributions (qualified medical)
- Qualified Charitable Distributions (QCDs)
- Veterans' disability benefits
- Life insurance proceeds
- Reverse mortgage payments
- Return of principal (non-taxable)
- Gifts and inheritances
How to Appeal Your IRMAA Determination
If you experienced a qualifying life event that reduced your income, you can request a new determination using SSA Form SSA-44. Qualifying events include:
Retirement or work reduction • Marriage or divorce • Death of a spouse • Loss of income-producing property • Loss of pension • Employer settlement payment
Appeal Process
Collect proof of your life event (retirement letter, divorce decree, death certificate, etc.)
Download from ssa.gov and fill out the form requesting a new initial determination
File in person at your local SSA office, by mail, or by fax
They will use your updated income to recalculate your IRMAA tier
If approved, your premiums will be adjusted — sometimes retroactively with a refund
⏰ Important: You have 60 days from receiving your IRMAA notice to file an appeal. Don't wait — contact us if you need help.
How MereBenefits Helps With IRMAA
📊 IRMAA Impact Analysis
We review your income situation and show you exactly which tier you fall into and what you'll pay.
📋 Income Planning Strategy
Guidance on Roth conversions, QCDs, and timing strategies to manage MAGI before the lookback window.
📝 Appeal Assistance
If you qualify for an IRMAA appeal, we help you gather documents and navigate the SSA-44 process.
🔗 Medicare Plan Coordination
We ensure your Medicare Advantage, Supplement, or Part D plan is optimized alongside your IRMAA costs.
Frequently Asked Questions
IRMAA is an extra charge on your Medicare Part B and Part D premiums if your MAGI exceeds $109,000 (individual) or $218,000 (joint). There are 5 tiers — the higher your income, the more you pay on top of the standard $202.90/month Part B premium.
Social Security uses a 2-year lookback. For 2026 premiums, they use your 2024 tax return (MAGI reported to IRS).
No. Qualified Roth IRA distributions are not included in MAGI and do not trigger IRMAA surcharges. However, Roth conversions do count in the year the conversion occurs.
Yes. If you experienced a qualifying life event (retirement, job loss, divorce, death of spouse, etc.), you can file Form SSA-44 to request that Social Security use your more recent, lower income. You have 60 days from receiving your notice.
Yes. IRMAA applies to Part B and Part D regardless of whether you have Original Medicare or Medicare Advantage. The surcharge is billed by Medicare directly, not your plan.
Yes. Each spouse on Medicare pays the IRMAA surcharge individually, even though the income thresholds are based on your joint MAGI.
Strategies include: completing Roth conversions before age 63 (before the lookback window), using qualified charitable distributions (QCDs) from IRAs, timing capital gains, managing retirement withdrawals, and leveraging HSA contributions. Planning 2+ years ahead is critical.
The standard 2026 Part B premium is $202.90/month — everyone pays this. IRMAA is an additional surcharge on top, ranging from $81.20 to $487.00 extra per month depending on your income tier.
Modified Adjusted Gross Income (MAGI) = AGI + tax-exempt interest + untaxed Social Security benefits. Your AGI is on Line 11 of IRS Form 1040. MAGI is what Social Security uses to determine your IRMAA tier.
IRMAA is assessed when you first enroll and recalculated each year. Your first determination uses your tax return from 2 years prior to your enrollment year.